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Organization

INSTITUTE FOR SPINE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MACHELLE GIORDON (CREDENTIALING SPECIALIST)
(330) 723-2111
Entity
Organization

Contact information

Practice address
7551 FREDLE DR, CONCORD TWP, OH 44077-9406
(440) 357-1502
(440) 357-1905
Mailing address
7551 FREDLE DR, CONCORD TWP, OH 44077-9406
(440) 357-1502
(440) 357-1905

Taxonomy

Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
35056000
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0880480
OH
Enumeration date
06/13/2006
Last updated
11/03/2010
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