| Organization Name: | ORTHO SPINE & PAIN CLINIC LLC |
| NPI Number: | 1558662395 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | COLLEEN LOUW (OWNER) |
| Mailing Address: | 618 Broad St Suite A Story City |
| State: | IA US |
| Postal Code: | 502481255 |
| Phone Number: | 2084679117 |
| Fax Number: | 5157332744 |
| NPI Enumeration Date: | 11/10/2010 |
| NPI Last Update Date: | 04/30/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251N0400X |
| License Number: | 004383 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Neurology |
| Taxonomy Definition: | |