Provider Demographics
NPI:1831984400
Name:SPINE & SPORTS CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:SPINE & SPORTS CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:KALLIO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-980-1388
Mailing Address - Street 1:93 CIRCLE CITY WAY
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-1808
Mailing Address - Country:US
Mailing Address - Phone:402-980-1388
Mailing Address - Fax:
Practice Address - Street 1:35 SUTTLES RD STE 150
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-5531
Practice Address - Country:US
Practice Address - Phone:402-980-1388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty