Provider Demographics
NPI:1104097922
Name:ADVANCED SPINE CARE, P.S.
Entity type:Organization
Organization Name:ADVANCED SPINE CARE, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:J
Authorized Official - Last Name:FITZPATRICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC, LMP
Authorized Official - Phone:360-754-2915
Mailing Address - Street 1:PO BOX 12955
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98508-2955
Mailing Address - Country:US
Mailing Address - Phone:360-754-2915
Mailing Address - Fax:360-754-6919
Practice Address - Street 1:1700 COOPER POINT RD SW
Practice Address - Street 2:SUITE A-1
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-1104
Practice Address - Country:US
Practice Address - Phone:360-754-2915
Practice Address - Fax:360-754-6919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty