Provider Demographics
NPI:1295729473
Name:SPINAL REHAB SPECIALISTS
Entity type:Organization
Organization Name:SPINAL REHAB SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE BILLING SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-292-2146
Mailing Address - Street 1:1704 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-8011
Mailing Address - Country:US
Mailing Address - Phone:801-221-2999
Mailing Address - Fax:801-224-3235
Practice Address - Street 1:1704 S STATE ST
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84097-8011
Practice Address - Country:US
Practice Address - Phone:801-221-2999
Practice Address - Fax:801-224-3235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2640381202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT32346OtherPEHP
UT159151OtherDMBA
UT107000867101OtherIHC
UT5241711600001OtherBLUECROSS BLUESHIELD
U46175Medicare UPIN