Organization
CENTER FOR SPINE INTERVENTIONS ASC 1 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE RAYA (OFFICE MANAGER)
(678) 813-2741
Entity
Organization
Contact information
Practice address
4586 TIMBER RIDGE DR STE 141, DOUGLASVILLE, GA 30135-7517
(678) 813-2741
(770) 575-3912
Mailing address
2713 CHARLES HARDY PKWY STE 212, DALLAS, GA 30157-9445
(678) 813-2741
(770) 575-3912
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
08/06/2013
Last updated
07/22/2021
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