Organization
SOUTH EAST SPONE CARE & PAIN MGMT
Active
Parent organization
SOUTEAST SPINE CARE AND PAIN MANAGEMENT
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTEAST SPINE CARE AND PAIN MANAGEMENT
Authorized official
ORTELIO BOSCH MD (OWNER)
(912) 233-6811
Entity
Organization
Contact information
Practice address
7450 SKIDAWAY RD, SUITE B, SAVANNAH, GA 31406
(912) 233-6811
(912) 544-0864
Mailing address
7450 SKIDAWAY RD, SUITE B, SAVANNAH, GA 31406
(912) 233-6811
(912) 544-0864
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000966139D
—
GA
Enumeration date
04/04/2013
Last updated
04/04/2013
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