# EASTSIDE SPINE & PAIN CENTER

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

## Provider details

- **NPI number:** 1649509605
- **Authorized official:** DR. MARIE N. SORACCO D.C. (CLINIC DIRECTOR)
- **Authorized official phone:** (770) 979-2225

## Contact information

- **Practice address:** 1580 TREE LN, SNELLVILLE, GA 30078-2207
- **Practice address phone:** (770) 979-2225
- **Practice address fax:** (770) 979-8348
- **Mailing address:** PO BOX 325, SNELLVILLE, GA 30078-0325
- **Mailing address phone:** (770) 979-2225
- **Mailing address fax:** (770) 979-8348

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NR0400X | Rehabilitation Chiropractor | CHIR002563 | GA | Yes |

## Other

- **Enumeration date:** 12/21/2009
- **Last updated:** 12/21/2009