Organization
AMBULATORY SPINE PROCEDURE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TED GROSBECK (MANAGER)
(469) 916-0521
Entity
Organization
Contact information
Practice address
17110 DALLAS PKWY, SUITE 125, DALLAS, TX 75248-1167
(469) 916-0521
(972) 234-0212
Mailing address
PO BOX 269083, OKLAHOMA CITY, OK 73126-9083
(469) 916-0521
(972) 234-0212
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
12/08/2009
Last updated
06/06/2016
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