Organization
RENEW SPINE CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASEN TODD VAN DYKE DC (OWNER)
(828) 883-8262
Entity
Organization
Contact information
Practice address
6 PARK PL W, BREVARD, NC 28712-3081
(828) 883-8262
(828) 883-8264
Mailing address
6 PARK PL W, BREVARD, NC 28712-3081
(828) 883-8262
(828) 883-8264
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4464
NC
Other
Enumeration date
08/15/2014
Last updated
12/02/2022
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