Organization
SPINE CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANICE LYNN KLEIN (PRESIDENT)
(314) 432-7100
Entity
Organization
Contact information
Practice address
555 N NEW BALLAS RD, SUITE 120, SAINT LOUIS, MO 63141-6825
(314) 432-7100
Mailing address
555 N NEW BALLAS RD, SUITE 120, SAINT LOUIS, MO 63141-6825
(314) 432-7100
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT01954
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101170
BLUE SHIELD
MO
01
—
6400302
UNITED HEALTHCARE
MO
Enumeration date
01/19/2007
Last updated
07/13/2014
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