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Organization

SPORT & SPINE, INC.

Active
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Organization

SPORT & SPINE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GREG ROTHSTEIN (SECRETARY)
(714) 609-7966
Entity
Organization

Contact information

Practice address
9121 ATLANTA AVE, # 532, HUNTINGTON BEACH, CA 92646-6309
(714) 609-7966
Mailing address
9121 ATLANTA AVE, # 532, HUNTINGTON BEACH, CA 92646-6309

Taxonomy

Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
25792
CA
111NS0005X
Sports Physician Chiropractor
Primary
25792
CA

Other

Enumeration date
01/12/2009
Last updated
01/12/2009
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