Organization
ADVANCED SPINE ENDOSCOPY AND PAIN INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUNNA DAVIES (MANAGER)
(240) 367-9601
Entity
Organization
Contact information
Practice address
915 TOLL HOUSE AVE STE 207, FREDERICK, MD 21701-5901
(240) 367-9601
Mailing address
915 TOLL HOUSE AVE STE 207, FREDERICK, MD 21701-5901
(240) 367-9601
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600218800
—
MD
Enumeration date
10/29/2018
Last updated
10/29/2018
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