Organization
LIFE ORTHOPAEDIC & SPINE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DASHAWN BAKARI M.D. (OWNER)
(770) 477-1115
Entity
Organization
Contact information
Practice address
6584 PROFESSIONAL PL, SUITE A, RIVERDALE, GA 30274-4942
(770) 477-1115
(770) 477-1119
Mailing address
6584 PROFESSIONAL PL, SUITE A, RIVERDALE, GA 30274-4942
(770) 477-1115
(770) 477-1119
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0620697
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032883905A
—
GA
Enumeration date
12/17/2009
Last updated
05/04/2016
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