Spine Innovations, LLC

NPI #1366973935 in Lacombe, Louisiana

Provider Information

NPI Number: 1366973935
Entity Type: Organization
Organization Name: Spine Innovations, LLC
Primary Specialty: Specialist
Enumeration Date: Mar 24, 2017
Last Updated: Mar 24, 2017

Practice Location

Address: 29301 N DIXIE RANCH RD
City: Lacombe
State: Louisiana
ZIP Code: 70445-5403
Phone: (985) 871-4114

Authorized Official

Name: DR. DONALD D DIETZE, M.D.
Title: OWNER
Phone: (985) 871-4114

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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