| Organization Name: | VININGS SPINE & HEALTH CENTER, LLC |
| NPI Number: | 1225462369 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RAYMOND EASLEY (MEDICAL DIRECTOR) |
| Mailing Address: | 1675 Cumberland Pkwy Se Suite 205 Smyrna |
| State: | GA US |
| Postal Code: | 300806359 |
| Phone Number: | 7709559355 |
| Fax Number: | 8777221023 |
| NPI Enumeration Date: | 08/26/2013 |
| NPI Last Update Date: | 11/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 66224 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |