| Organization Name: | ADVANCED SPINE & SPORT MEDICAL REHABILITATION CENTER, INC |
| NPI Number: | 1659765980 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES BARANSKI (OWNER/CHIROPRACTOR) |
| Mailing Address: | 4601 Telephone Rd Suite 110 Ventura |
| State: | CA US |
| Postal Code: | 930035670 |
| Phone Number: | 8056424061 |
| Fax Number: | 8056427295 |
| NPI Enumeration Date: | 03/25/2015 |
| NPI Last Update Date: | 03/25/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 20A4668 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |