Provider Demographics
NPI:1275126476
Name:ARTHRA SPINE AND PAIN LLC
Entity Type:Organization
Organization Name:ARTHRA SPINE AND PAIN LLC
Other - Org Name:ARTHRO ACCIDENT & INJURY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-606-0712
Mailing Address - Street 1:615 COLONIAL PARK DR STE 105
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-3772
Mailing Address - Country:US
Mailing Address - Phone:404-737-8101
Mailing Address - Fax:
Practice Address - Street 1:615 COLONIAL PARK DR STE 105
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-3772
Practice Address - Country:US
Practice Address - Phone:404-737-8101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-18
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty