Provider Demographics
NPI:1649455759
Name:SPINAL MEDICAL SYSTEMS
Entity type:Organization
Organization Name:SPINAL MEDICAL SYSTEMS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:WECHSLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:407-677-6686
Mailing Address - Street 1:4270 ALOMA AVE
Mailing Address - Street 2:SUITE 162
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-9424
Mailing Address - Country:US
Mailing Address - Phone:407-677-6686
Mailing Address - Fax:407-677-9990
Practice Address - Street 1:4270 ALOMA AVE
Practice Address - Street 2:SUITE 162
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-9424
Practice Address - Country:US
Practice Address - Phone:407-677-6686
Practice Address - Fax:407-677-9990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3515111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty