Provider Demographics
NPI:1871656561
Name:NON-SURGICAL ORTHOPAEDICS PC
Entity Type:Organization
Organization Name:NON-SURGICAL ORTHOPAEDICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRASSO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-421-1420
Mailing Address - Street 1:335 ROSELANE ST
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-6969
Mailing Address - Country:US
Mailing Address - Phone:770-421-1420
Mailing Address - Fax:770-421-8055
Practice Address - Street 1:335 ROSELANE ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-6969
Practice Address - Country:US
Practice Address - Phone:770-421-1420
Practice Address - Fax:770-421-8055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA00053640174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP2941Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER