Organization
GEORGIA SPORTS AND PAIN PHYSICIANS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN HELMS CPC (CREDENTIALING AGENT)
(850) 547-5789
Entity
Organization
Contact information
Practice address
4900 IVEY RD NW, SUITE 810, ACWORTH, GA 30101-4001
(850) 547-5789
(850) 547-5789
Mailing address
4900 IVEY RD NW, SUITE 810, ACWORTH, GA 30101-4001
(850) 547-5789
(850) 547-5789
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
059870
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
059870
MEDICAL LICENSE
GA
Enumeration date
05/24/2010
Last updated
05/24/2010
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