# GWINNETT SPINE SPECIALISTS LLC

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

## Provider details

- **NPI number:** 1841736303
- **Authorized official:** MRS. ANGELA S PIRTLE CPC (BILLING MANAGER)
- **Authorized official phone:** (770) 755-9137

## Contact information

- **Practice address:** 1625 PLEASANT HILL RD, SUITE 215, DULUTH, GA 30096-2326
- **Practice address phone:** (470) 299-6859
- **Practice address fax:** (470) 299-8397
- **Mailing address:** 1625 PLEASANT HILL RD, SUITE 215, DULUTH, GA 30096-2326
- **Mailing address phone:** (470) 299-6859
- **Mailing address fax:** (470) 299-8397

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | CHIRO08008 | GA | — |
| 208D00000X | General Practice Physician | 1831215714 | GA | Yes |

## Other

- **Enumeration date:** 01/09/2017
- **Last updated:** 01/09/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1043336498 | NPI NUMBER | GA |
| 01 | — | 202I013104 | MEDCARE PTAN NUMBER | GA |