Provider Demographics
NPI:1679315444
Name:SPINE THERAPY ASSOCIATES LLC
Entity type:Organization
Organization Name:SPINE THERAPY ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:CARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:YANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-507-0800
Mailing Address - Street 1:2031 PALM BEACH LAKES BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-6525
Mailing Address - Country:US
Mailing Address - Phone:561-331-8825
Mailing Address - Fax:
Practice Address - Street 1:2031 PALM BEACH LAKES BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6525
Practice Address - Country:US
Practice Address - Phone:561-331-8825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty