Organization
COMPREHENSIVE SPINE CARE
Active
Organization
COMPREHENSIVE SPINE CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAMAL KUMAR TIWARI MD (PRESIDENT/OWNER)
(812) 333-7246
Entity
Organization
Contact information
Practice address
2499 W COTA DR, BLOOMINGTON, IN 47403-4217
(812) 337-0210
(812) 337-0211
Mailing address
PO BOX 5637, ATTN: MARIA MITCHELL, BLOOMINGTON, IN 47407-5637
(812) 824-5688
(812) 824-5692
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
50004448A
IN
Other
Enumeration date
09/15/2005
Last updated
11/14/2007
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