# PACIFIC SPINE & REHAB, LLC

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

## Provider details

- **NPI number:** 1992999536
- **Authorized official:** DR. ROBERT D. HEROS M.D. (OWNER / MEMBER)
- **Authorized official phone:** (503) 364-1990

## Contact information

- **Practice address:** 2480 LIBERTY ST NE, STE 180, SALEM, OR 97301-8388
- **Practice address phone:** (503) 364-1990
- **Practice address fax:** (503) 391-4688
- **Mailing address:** 2480 LIBERTY ST NE, STE 180, SALEM, OR 97301-8388
- **Mailing address phone:** (503) 364-1990
- **Mailing address fax:** (503) 391-4688

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | MD27619 | OR | Yes |

## Other

- **Enumeration date:** 08/28/2007
- **Last updated:** 03/06/2008