Organization
SJ & J SPINE AND PAIN GROUP HOLDING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SALLU JABATI (MD/MEDICAL DIRECTOR)
(678) 559-4526
Entity
Organization
Contact information
Practice address
91 SAMMY MCGHEE BLVD, SUITE 101, JASPER, GA 30143
(706) 253-3341
Mailing address
91 SAMMY MCGHEE BLVD, SUITE 101, JASPER, GA 30143
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
058527
GA
208VP0014X
Interventional Pain Medicine Physician
Primary
058527
GA
Other
Enumeration date
08/04/2015
Last updated
08/04/2015
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