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Organization

DYNAMIC SPINE II CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RANDALL RANSOM (CEO)
(334) 322-0906
Entity
Organization

Contact information

Practice address
21 MARKET SQUARE WAY STE 103, NEWNAN, GA 30265-5712
(770) 229-6141
Mailing address
21 MARKET SQUARE WAY STE 103, NEWNAN, GA 30265-5712

Taxonomy

Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary

Other

Enumeration date
12/05/2018
Last updated
12/05/2018
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