| NPI | 1194274001 |
|---|---|
| Former Legal Business Name | SPINE CENTER CONYERS,LLC |
| Entity Type | Organization |
| Authorized Contact | STEVEN WEIDLER Chief Operating Officer 404-351-5812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 208VP0000X |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2018-12-14 |