| Fine Spine Llc | |
|
709 East Loop 820 Fort Worth TX 76120 | |
| (817) 451-7979 | |
| (817) 451-7545 |
| Full Name | Fine Spine Llc |
|---|---|
| Speciality | Chiropractor |
| Location | 709 East Loop 820, Fort Worth, Texas |
| Authorized Official Name and Position | Stacy Peters Harris (DIRECTOR/ADMINISTRATOR) |
| Authorized Official Contact | 8174517979 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fine Spine Llc 709 East Loop 820 Fort Worth TX 76120 Ph: (817) 451-7979 | Fine Spine Llc 709 East Loop 820 Fort Worth TX 76120 Ph: (817) 451-7979 |
| NPI Number | 1487677357 |
|---|---|
| Provider Enumeration Date | 07/25/2006 |
| Last Update Date | 01/11/2008 |
| Medicare PECOS PAC ID | 9234156118 |
|---|---|
| Medicare Enrollment ID | O20060112000697 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487677357 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 111N00000X | Chiropractor | (* (Not Available)) | Primary |
| Provider Name | Stacy P Harris |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1811902125 PECOS PAC ID: 6305863291 Enrollment ID: I20060113000144 |
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