Organization
GWINNETT SPINE SPECIALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA S PIRTLE CPC (BILLING MANAGER)
(770) 755-9137
Entity
Organization
Contact information
Practice address
1625 PLEASANT HILL RD, SUITE 215, DULUTH, GA 30096-2326
(470) 299-6859
(470) 299-8397
Mailing address
1625 PLEASANT HILL RD, SUITE 215, DULUTH, GA 30096-2326
(470) 299-6859
(470) 299-8397
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CHIRO08008
GA
208D00000X
General Practice Physician
Primary
1831215714
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043336498
NPI NUMBER
GA
01
—
202I013104
MEDCARE PTAN NUMBER
GA
Enumeration date
01/09/2017
Last updated
01/09/2017
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