Provider Demographics
NPI:1518702240
Name:SPINE REHAB NATION
Entity type:Organization
Organization Name:SPINE REHAB NATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:AUER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-456-1052
Mailing Address - Street 1:3202 FERNWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:MD
Mailing Address - Zip Code:21013-9543
Mailing Address - Country:US
Mailing Address - Phone:410-456-1052
Mailing Address - Fax:
Practice Address - Street 1:1965 GREENSPRING DR STE G9
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-4137
Practice Address - Country:US
Practice Address - Phone:410-449-2529
Practice Address - Fax:410-867-3046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-25
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty