Organization Name: | PHYSICIANS SPINE AND REHAB SPECIALISTS OF GA |
NPI Number: | 1710946322 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KEITH CASSIDY RAZIANO (MANAGING PARTNER / OWNER) |
Mailing Address: | 5730 Glenridge Dr Ne Suite 100 Sandy Springs |
State: | GA US |
Postal Code: | 303286141 |
Phone Number: | 4048163000 |
Fax Number: | |
NPI Enumeration Date: | 03/22/2006 |
NPI Last Update Date: | 04/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 050988 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |