Organization
SPINE CENTER OF PA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANISH PATEL MD (OWNER)
(301) 620-0012
Entity
Organization
Contact information
Practice address
2374 VILLAGE COMMON DR STE 100, ERIE, PA 16506-7201
(814) 833-7246
Mailing address
3060 WILLIAMS DR STE 510, FAIRFAX, VA 22031-4648
(703) 789-1929
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
12/31/2019
Last updated
12/31/2019
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