# ORTHO KINETIC SPINE AND REHAB, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104552272
- **Authorized official:** AKILIAH JOHNSON DC (OWNER)
- **Authorized official phone:** (202) 277-2255

## Contact information

- **Practice address:** 2000 POWERS FERRY RD SE STE 2206, MARIETTA, GA 30067-1203
- **Practice address phone:** (470) 394-0111
- **Practice address fax:** (470) 443-1707
- **Mailing address:** 1089 WATERBURY CLOSE, POWDER SPRINGS, GA 30127-4942

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/29/2022
- **Last updated:** 07/29/2022