| NPI | 1639584378 |
|---|---|
| Doing Business As | SOUTHERN SPINE & PAIN INSTITUTE |
| Entity Type | Organization |
| Authorized Contact | ANTHONY THADDEUS CLAVO President/Owner 770-632-3730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: GA 045425) |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2014-06-20 |