Organization
INTERVENTIONAL SPINE AND PAIN MANAGEMENT AMBULATORY SURGICAL CENTER
Active
Other names
ISPM ASC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICTORIA BECK (CFO)
(404) 920-4950
Entity
Organization
Contact information
Practice address
1388 WELLBROOK CIR NE, SUITE A, CONYERS, GA 30012-3872
(770) 929-9033
(770) 929-9092
Mailing address
PO BOX 11407 DEPT 2344, BIRMINGHAM, AL 35246-3872
(770) 929-9033
(770) 929-9092
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
GA
Other
Enumeration date
02/05/2007
Last updated
02/29/2020
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