Provider Demographics
NPI:1588421838
Name:SPINE MOTION DX II LLC
Entity type:Organization
Organization Name:SPINE MOTION DX II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-518-3112
Mailing Address - Street 1:101 N WOODLAND BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-4247
Mailing Address - Country:US
Mailing Address - Phone:888-473-2909
Mailing Address - Fax:888-473-5564
Practice Address - Street 1:101 N WOODLAND BLVD STE 210
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-4247
Practice Address - Country:US
Practice Address - Phone:888-473-2909
Practice Address - Fax:888-473-5564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty