Organization
COBB REGENERATIVE & JOINT CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIXTO GONZALEZ (OPERATING MANAGER/OWNER)
(770) 485-8298
Entity
Organization
Contact information
Practice address
1050 SHILOH RD NW STE 305, KENNESAW, GA 30144-8100
(770) 485-8298
(770) 234-5215
Mailing address
1050 SHILOH RD NW STE 305, KENNESAW, GA 30144-8100
(770) 485-8298
(770) 234-5215
Taxonomy
Speciality
Code
Description
License number
State
163WP0000X
Pain Management Registered Nurse
—
—
174400000X
Specialist
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
05/19/2021
Last updated
08/07/2023
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