Provider Demographics
NPI:1629329008
Name:GEORGIA SPINAL HEALTH & WELLNESS INC
Entity Type:Organization
Organization Name:GEORGIA SPINAL HEALTH & WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:G
Authorized Official - Last Name:HOCHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:404-325-0080
Mailing Address - Street 1:2021 N DRUID HILLS RD NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-1832
Mailing Address - Country:US
Mailing Address - Phone:404-325-0080
Mailing Address - Fax:404-325-0085
Practice Address - Street 1:2021 N DRUID HILLS RD NE
Practice Address - Street 2:SUITE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-1832
Practice Address - Country:US
Practice Address - Phone:404-325-0080
Practice Address - Fax:404-325-0085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty