Organization
ACE PAIN AND SPINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORY MANSOUR MD (PHYSICIAN / OWNER)
(678) 889-2326
Entity
Organization
Contact information
Practice address
3625 BRASELTON HWY STE 201, DACULA, GA 30019-4695
(678) 404-2220
Mailing address
3625 BRASELTON HWY STE 201, DACULA, GA 30019-4695
(678) 889-2326
(470) 238-3658
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Enumeration date
07/09/2020
Last updated
07/20/2021
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