Back & Spine Medical Institute

LBN: Back & Spine Medical Institute
Back & Spine Medical Institute is an health care organization with primary practice located at 5300 N Illinois St , Fairview Heights IL 62208-3500. The organization recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as the primary health care specialty. Back & Spine Medical Institute can be contacted via phone (618) 222-2222, or through Johnson, Randy via phone (314) 781-8082.

Contact Information

Primary practice address
5300 N Illinois St Fairview Heights IL 62208-3500
Phone: (618) 222-2222
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Randy
Phone: (314) 781-8082

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X Illinois

Profile Details

NPI number 1871690081
LBN Legal business name Back & Spine Medical Institute
DBA Doing business as
Authorized official Johnson, Randy
Entity Organization
Organization subpart 1 No
Enumeration date Sep 20th, 2006
Last updated Nov 16th, 2007 - about 19 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871690081 NPPES
Illinois Other DE2495 RR MEDICARE GROUP#

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