Organization
SPINE CENTER ATLANTA EAST, LLC
Active
Other names
Spine Center Conyers,LLC
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN WEIDLER (CHIEF OPERATING OFFICER)
(404) 351-5812
Entity
Organization
Contact information
Practice address
1309 WELLBROOK CIR., STE H, CONYERS, GA 30012-3873
(678) 263-2020
(678) 608-3217
Mailing address
3161 HOWELL MILL RD NW, STE 310, ATLANTA, GA 30327-2132
(404) 351-5812
(678) 608-3217
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
10/04/2016
Last updated
12/14/2018
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