Organization
THE SPINE GROUP OF VIRGINIA P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SPENCER DANIEL JOHANSEN D.C. (PRESIDENT)
(757) 422-2000
Entity
Organization
Contact information
Practice address
2416 VIRGINIA BEACH BLVD, VIRGINIA BEACH, VA 23454-3993
(757) 422-2000
(757) 422-1151
Mailing address
2416 VIRGINIA BEACH BLVD, VIRGINIA BEACH, VA 23454-3993
(757) 422-2000
(757) 422-1151
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104001208
VA
Other
Enumeration date
08/31/2006
Last updated
12/07/2007
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