# BARRACK SPINE AND JOINT MEDICINE, INC.

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

## Provider details

- **NPI number:** 1285967489
- **Authorized official:** LATASHA LYMAN (BUSINESS MANAGER)
- **Authorized official phone:** (678) 738-7601

## Contact information

- **Practice address:** 1230 JOHNSON FERRY PL, SUITE H-15/20, MARIETTA, GA 30068-2048
- **Practice address phone:** (678) 738-7601
- **Practice address fax:** (678) 738-7605
- **Mailing address:** 1230 JOHNSON FERRY PL, SUITE H-15/20, MARIETTA, GA 30068-2048
- **Mailing address phone:** (678) 738-7601
- **Mailing address fax:** (678) 738-7605

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/08/2009
- **Last updated:** 09/13/2010