Provider Demographics
NPI:1801495841
Name:NEURO HEALTH SC LLC
Entity type:Organization
Organization Name:NEURO HEALTH SC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:SPINOSO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-940-3682
Mailing Address - Street 1:108 COMMONS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:SC
Mailing Address - Zip Code:29673-7766
Mailing Address - Country:US
Mailing Address - Phone:864-940-3682
Mailing Address - Fax:
Practice Address - Street 1:108 COMMONS BLVD STE A
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:SC
Practice Address - Zip Code:29673-7766
Practice Address - Country:US
Practice Address - Phone:864-940-3682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty