Provider Demographics
NPI:1689468308
Name:VIP SPINE PLLC
Entity type:Organization
Organization Name:VIP SPINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:SPENCER
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-444-6798
Mailing Address - Street 1:7455 W AZURE DR STE 140
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-4431
Mailing Address - Country:US
Mailing Address - Phone:702-765-4222
Mailing Address - Fax:702-718-6652
Practice Address - Street 1:7455 W AZURE DR STE 140
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-4431
Practice Address - Country:US
Practice Address - Phone:702-765-4222
Practice Address - Fax:702-718-6652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain