Organization
FX SPINE AND PERFORMANCE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS ALLAN DEANGELO DO (PRESIDENT)
(717) 557-5926
Entity
Organization
Contact information
Practice address
106 SRP DR STE B, EVANS, GA 30809-4358
(706) 842-6800
(706) 842-6780
Mailing address
824 KESTREL DR, EVANS, GA 30809-0328
(717) 557-5926
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
261QP3300X
Pain Clinic/Center
—
—
Other
Enumeration date
07/24/2020
Last updated
12/03/2020
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