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Organization

SPINE CENTER ATLANTA NORTH, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEVEN WEIDLER (CFO)
(404) 351-5812
Entity
Organization

Contact information

Practice address
3540 DULUTH PARK LN STE 120, DULUTH, GA 30096-3200
(404) 458-9956
Mailing address
3161 HOWELL MILL RD NW STE 310, ATLANTA, GA 30327-2132
(404) 351-5812

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
208100000X
Physical Medicine & Rehabilitation Physician
208VP0000X
Pain Medicine Physician

Other

Enumeration date
12/19/2018
Last updated
12/19/2018
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