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Contact Information

ATLANTA SPORTS AND SPINE LLC
2340 PATRICK HENRY PKWY
150
MCDONOUGH, GA30253-4325
 Phone: 678-866-3646
 Fax: 678-804-6862
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
 

Electrodiagnostic Medicine

204R00000X
 

Sports Medicine

2081S0010X 25 Physician/Physical Medicine and Rehabilitation
Indicates primary specialty

NPI Profile & details for ATLANTA SPORTS AND SPINE LLC · (Female)

NPI Number 1720439136
Status Active
Credentials
Entity Individual
Enumeration date 06/27/2016
Last updated 05/11/2018 - About 8 years ago
Sole proprietor 1 Not specified
Identifiers
  • GA License # 067950
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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