Organization Name: | INTEGRATED SPINAL SOLUTIONS, PLLC |
NPI Number: | 1104247634 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRADLEY J KENESON (DOCTOR OF OSTEOPATHIC MEDICINE) |
Mailing Address: | 649 Ne Alsbury Blvd Ste 105 Burleson |
State: | TX US |
Postal Code: | 760282660 |
Phone Number: | 8177683899 |
Fax Number: | |
NPI Enumeration Date: | 12/31/2013 |
NPI Last Update Date: | 12/31/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |