Provider Demographics
NPI:1871609834
Name:SPINE INTERVENTION CENTER, LLC
Entity type:Organization
Organization Name:SPINE INTERVENTION CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:SALDANHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-273-2571
Mailing Address - Street 1:998 HOSPITALITY WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:ABERDEEN
Mailing Address - State:MD
Mailing Address - Zip Code:21001-1779
Mailing Address - Country:US
Mailing Address - Phone:410-273-2571
Mailing Address - Fax:
Practice Address - Street 1:998 HOSPITALITY WAY
Practice Address - Street 2:SUITE A
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-1779
Practice Address - Country:US
Practice Address - Phone:410-273-2571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical