Organization
INSTITUTE FOR SPINE INC
Active
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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