| NPI | 1548795719 |
|---|---|
| Former Legal Business Name | SPINE CENTER RIVERDALE, LLC |
| Entity Type | Organization |
| Authorized Contact | STEVEN WEIDLER Chief Operating Officer 404-351-5812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: GA 063309) |
| 208VP0000X Pain Medicine Pain Medicine | |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2018-12-14 |