Organization
SPINE TECHNOLOGY AND REHABILITATION PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH FORTIN DO (PHYSICIAN OWNER)
(260) 459-7313
Entity
Organization
Contact information
Practice address
3898 NEW VISION DR, SUITE B, FORT WAYNE, IN 46845-1718
(260) 459-7313
(260) 436-0628
Mailing address
3898 NEW VISION DR, SUITE B, FORT WAYNE, IN 46845-1718
(260) 459-7313
(260) 436-0628
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
03/03/2008
Last updated
01/11/2011
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