# SPINE & SPORTS SPECIALTIES

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

## Provider details

- **NPI number:** 1801999057
- **Authorized official:** MR. JAMIE GEORGE SMITH MSPT, ATC, CSCS (OWNER)
- **Authorized official phone:** (225) 647-1515

## Contact information

- **Practice address:** 2012 S. BURNSIDE AVE., SUITE B, GONZALES, LA 70737-4637
- **Practice address phone:** (225) 647-1515
- **Practice address fax:** (225) 647-5151
- **Mailing address:** PO BOX 1991, GONZALES, LA 70707-1991
- **Mailing address phone:** (225) 647-1515
- **Mailing address fax:** (225) 647-5151

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | 02870 | LA | Yes |

## Other

- **Enumeration date:** 09/06/2006
- **Last updated:** 09/11/2007