Provider Demographics
NPI:1124316567
Name:SALEM PAIN AND SPINE SPECIALISTS PC
Entity type:Organization
Organization Name:SALEM PAIN AND SPINE SPECIALISTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:A
Authorized Official - Last Name:MONREAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-967-6771
Mailing Address - Street 1:1100 22ND ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-6558
Mailing Address - Country:US
Mailing Address - Phone:503-967-6771
Mailing Address - Fax:503-385-8421
Practice Address - Street 1:1100 22ND ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-6558
Practice Address - Country:US
Practice Address - Phone:503-967-6771
Practice Address - Fax:503-385-8421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-19
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty