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Organization
THE SPINE GROUP OF VIRGINIA P.C.
Active
Organization
THE SPINE GROUP OF VIRGINIA P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SPENCER DANIEL JOHANSEN D.C. (PRESIDENT)
(757) 422-2000
Entity
Organization
Contact information
Practice address
2416 VIRGINIA BEACH BLVD, VIRGINIA BEACH, VA 23454-3993
(757) 422-2000
(757) 422-1151
Mailing address
2416 VIRGINIA BEACH BLVD, VIRGINIA BEACH, VA 23454-3993
(757) 422-2000
(757) 422-1151
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104001208
VA
Other
Enumeration date
08/31/2006
Last updated
12/07/2007
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