Organization
USA LASER SPINE
Active
Other names
Dr. St. Louis Spine
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER FRIEND (ADMINISTRATOR)
(727) 494-9004
Entity
Organization
Contact information
Practice address
4728 N HABANA AVE STE 303, TAMPA, FL 33614-7183
(833) 752-0404
Mailing address
4532 W KENNEDY BLVD # 108, TAMPA, FL 33609-2042
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
—
—
Other
Enumeration date
06/15/2021
Last updated
06/15/2021
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