Organization
FAST TRACK SPINE AND SPORTS MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHELLEY BOONE MD (PHYSICIAN)
(412) 855-7430
Entity
Organization
Contact information
Practice address
1643 W LANE AVE, COLUMBUS, OH 43221-3339
(614) 775-1503
(614) 775-1503
Mailing address
1643 W LANE AVE, COLUMBUS, OH 43221-3339
(614) 775-1503
(614) 317-3001
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
35-0088642
OH
Other
Enumeration date
03/26/2011
Last updated
11/14/2011
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