Organization
GEORGIA PAIN SPINE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA BECK (CFO)
(404) 403-8310
Entity
Organization
Contact information
Practice address
15 MEDICAL DRIVE, SUITE 302, CARTERSVILLE, GA 30121
(678) 337-3163
(770) 422-7306
Mailing address
PO BOX 11407 DEPT 2657, BIRMINGHAM, AL 35246-0001
(770) 920-4950
(770) 929-9092
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
261QP3300X
Pain Clinic/Center
008-311
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5665923
CCN AND FIRST HEALTH
GA
Enumeration date
08/16/2006
Last updated
02/20/2020
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