NEOSPINE PUYALLUP SPINE CENTER LLC NPI 1275510141

NPI Information

NEOSPINE PUYALLUP SPINE CENTER, LLC is an ambulatory surgical clinic center in Puyallup, WA. NEOSPINE PUYALLUP SPINE CENTER, LLC NPI is 1275510141. The provider is registered as an organization entity type.
The provider Is Doing Business As Microsurgical Spine Center.

The provider's business location address is:

1519 3RD ST SE
SUITE 102
PUYALLUP, WA
ZIP 98372-742
Phone: (253) 841-0705
Fax: (253) 841-4527

The provider's authorized official is Jennifer Boyd Baldock .
The authorized official title is Officer And Authorized Official and has the following contact phone number (615) 234-5954.

The CLIA number assigned to this NPI record is 50D1018734 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/30/2005 and was last updated on 6/9/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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