Organization
DECATUR ORTHO-NEURO GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY MAYFIELD (MEMBER)
(404) 373-0400
Entity
Organization
Contact information
Practice address
1376 CHURCH ST, DECATUR, GA 30030-1519
(404) 373-0400
Mailing address
1376 CHURCH ST, DECATUR, GA 30030-1519
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
GA
Other
Enumeration date
03/27/2015
Last updated
04/15/2015
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