# CONSERVATIVE SPINE & JOINT CENTER, LLC

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

## Provider details

- **NPI number:** 1932549540
- **Authorized official:** DR. RUBEN DIAZ M.D. (OWNER/DIRECTOR)
- **Authorized official phone:** (678) 232-0109

## Contact information

- **Practice address:** 720 OLD SNELLVILLE HWY, SUITE150, LAWRENCEVILLE, GA 30044-6216
- **Practice address phone:** (770) 601-4340
- **Practice address fax:** (770) 978-1324
- **Mailing address:** 516 SOSEBEE FARM RD UNIT 159, GRAYSON, GA 30017-0103
- **Mailing address phone:** (770) 601-4340
- **Mailing address fax:** (678) 442-1324

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 2081N0008X | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081N0008X | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 2081P0004X | Spinal Cord Injury Medicine Physician | — | NULL | — |
| 2081P0004X | Spinal Cord Injury Medicine Physician | — | — | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081S0010X | Sports Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 208VP0000X | Pain Medicine Physician | — | NULL | — |
| 208VP0000X | Pain Medicine Physician | — | — | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | NULL | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 06/27/2013
- **Last updated:** 09/24/2019