Organization Name: | LASER SPINE SURGERY CENTER OF CLEVELAND, LLC |
NPI Number: | 1275949570 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DOTTY J BOLLINGER (COO, PRESIDENT) |
Mailing Address: | 300 Allen Bradley Dr Mayfield Heights |
State: | OH US |
Postal Code: | 441246131 |
Phone Number: | 8132899613 |
Fax Number: | 4842531790 |
NPI Enumeration Date: | 07/08/2014 |
NPI Last Update Date: | 07/08/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA1903X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Ambulatory Surgical |
Taxonomy Definition: |