# FAST TRACK SPINE AND SPORTS MEDICINE LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639478894
- **Authorized official:** DR. SHELLEY BOONE MD (PHYSICIAN)
- **Authorized official phone:** (412) 855-7430

## Contact information

- **Practice address:** 1643 W LANE AVE, COLUMBUS, OH 43221-3339
- **Practice address phone:** (614) 775-1503
- **Practice address fax:** (614) 775-1503
- **Mailing address:** 1643 W LANE AVE, COLUMBUS, OH 43221-3339
- **Mailing address phone:** (614) 775-1503
- **Mailing address fax:** (614) 317-3001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 35-0088642 | OH | Yes |

## Other

- **Enumeration date:** 03/26/2011
- **Last updated:** 11/14/2011