Organization
BACK TO LIFE MEDICAL GROUP, LLC
Active
Other names
Spinal Medical Centers
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC A CAVACIUTI (OWNER)
(770) 345-2000
Entity
Organization
Contact information
Practice address
557 RIVERSTONE PKWY, SUITE 140, CANTON, GA 30114-5223
(770) 345-2000
(770) 345-4524
Mailing address
557 RIVERSTONE PKWY, SUITE 140, CANTON, GA 30114-5223
(770) 345-2000
(770) 345-4524
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
048997
GA
Other
Enumeration date
03/25/2009
Last updated
11/10/2014
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