# SPINE SPA

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

## Provider details

- **NPI number:** 1841592771
- **Authorized official:** DR. BRENDA A FAIRCHILD DC (PRESIDENT)
- **Authorized official phone:** (302) 731-0869

## Contact information

- **Practice address:** 300 CHRISTIANA MEDICAL CTR, CHRISTIANA, DE 19702-1653
- **Practice address phone:** (302) 731-0869
- **Practice address fax:** (302) 292-0669
- **Mailing address:** 101 BERWYCK CT, NEWARK, DE 19702-2078
- **Mailing address phone:** (302) 731-0869
- **Mailing address fax:** (302) 292-0669

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | F1-0000788 | DE | Yes |

## Other

- **Enumeration date:** 11/29/2010
- **Last updated:** 11/29/2010