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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