Provider Demographics
NPI:1720338676
Name:RANGE SPINE CENTER, PLLC
Entity Type:Organization
Organization Name:RANGE SPINE CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:ONGARO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:218-969-4928
Mailing Address - Street 1:4104 9TH AVE W
Mailing Address - Street 2:
Mailing Address - City:HIBBING
Mailing Address - State:MN
Mailing Address - Zip Code:55746-3020
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4104 9TH AVE W
Practice Address - Street 2:
Practice Address - City:HIBBING
Practice Address - State:MN
Practice Address - Zip Code:55746-3020
Practice Address - Country:US
Practice Address - Phone:218-969-4928
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-18
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5467111N00000X
MN5322111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty