Organization
ADVANCED SPINAL ORTHOTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN K SONG MD (DIRECT OWNER)
(773) 770-5980
Entity
Organization
Contact information
Practice address
3000 N HALSTED ST, SUITE 703, CHICAGO, IL 60657-5188
(773) 770-5980
(773) 296-9999
Mailing address
3000 N HALSTED ST, SUITE 703, CHICAGO, IL 60657-5188
(773) 770-5980
(773) 296-9999
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
036111342
IL
Other
Enumeration date
12/07/2012
Last updated
12/07/2012
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