Provider Demographics
NPI:1457759383
Name:SPINE & JOINT SOLUTIONS PLLC
Entity Type:Organization
Organization Name:SPINE & JOINT SOLUTIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:719-282-7850
Mailing Address - Street 1:1710 JET STREAM DR STE 110
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-3937
Mailing Address - Country:US
Mailing Address - Phone:719-282-7850
Mailing Address - Fax:719-282-7827
Practice Address - Street 1:1710 JET STREAM DR STE 110
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80921-3937
Practice Address - Country:US
Practice Address - Phone:719-282-7850
Practice Address - Fax:719-282-7827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-09
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0048826208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty