Organization
SPINE CLINIC OF BATON ROUGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE JOHN IVANICKY (OWNER)
(225) 766-5050
Entity
Organization
Contact information
Practice address
5211 ESSEN LN, SUITE 1, BATON ROUGE, LA 70809-3564
(225) 766-5050
(225) 766-2052
Mailing address
5211 ESSEN LN, SUITE 1, BATON ROUGE, LA 70809-3564
(225) 766-5050
(225) 766-2052
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
024904
LA
Other
Enumeration date
02/26/2007
Last updated
08/22/2020
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