Organization
ADVANTAGE SPINE CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER RUSSELL D.C. (ADMINISTRATOR)
(435) 656-0234
Entity
Organization
Contact information
Practice address
619 S BLUFF ST, SUITE 401, ST GEORGE, UT 84770-3853
(435) 656-0234
(435) 656-2622
Mailing address
619 S BLUFF ST, SUITE 401, ST GEORGE, UT 84770-3853
(435) 656-0234
(435) 656-2622
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
10/24/2010
Last updated
10/24/2010
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