Provider Demographics
NPI:1255528808
Name:ADVANCED SPINAL HEALTH LLC
Entity type:Organization
Organization Name:ADVANCED SPINAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:CHIN-WEI
Authorized Official - Last Name:FUH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-493-3055
Mailing Address - Street 1:PO BOX 701680
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74170-1680
Mailing Address - Country:US
Mailing Address - Phone:918-493-3055
Mailing Address - Fax:918-493-3056
Practice Address - Street 1:6670 S LEWIS AVE STE 102
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1033
Practice Address - Country:US
Practice Address - Phone:918-493-3055
Practice Address - Fax:918-493-3056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3705111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty