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Organization
ORTHO SPORT & SPINE PHYSICIANS COLUMBIA
Active
Organization
ORTHO SPORT & SPINE PHYSICIANS COLUMBIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WHITNEY GLOVER (CREDENTIALING)
(678) 783-7615
Entity
Organization
Contact information
Practice address
11 ATRIUM RIDGE CT, COLUMBIA, SC 29223-6438
(678) 752-7246
Mailing address
5788 ROSWELL RD, ATLANTA, GA 30328-4904
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
NULL
207X00000X
Orthopaedic Surgery Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
10/22/2018
Last updated
02/16/2023
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