Provider Demographics
NPI:1144522145
Name:SPINAL MECHANICS CENTERS
Entity type:Organization
Organization Name:SPINAL MECHANICS CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:KEMNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-433-0240
Mailing Address - Street 1:2409 N ROOSEVELT BLVD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-3837
Mailing Address - Country:US
Mailing Address - Phone:305-433-0240
Mailing Address - Fax:305-517-6470
Practice Address - Street 1:2409 N ROOSEVELT BLVD
Practice Address - Street 2:SUITE 9
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-3837
Practice Address - Country:US
Practice Address - Phone:305-433-0240
Practice Address - Fax:305-517-6470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-23
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9362111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL62308OtherCIGNA
FL64352OtherBC/BS FL
FL60054OtherAETNA
FL12151915OtherCAQH
FL12151915OtherCAQH