Organization
SPINESOURCE AMERICA, L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIM M CLIFTON (CHIEF OPERATING OFFICER)
(859) 260-8576
Entity
Organization
Contact information
Practice address
354 WALLER AVE, STE. 110, LEXINGTON, KY 40504-2928
(859) 260-8576
(859) 201-1088
Mailing address
354 WALLER AVE, STE. 102, LEXINGTON, KY 40504-2916
(859) 260-8576
(859) 201-1088
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
07/01/2005
Last updated
08/22/2020
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