Ortho Sport & Spine Physicians Kennesaw
Physical Medicine & Rehabilitation in Kennesaw, GA. Organization (NPI-2).
NPI number1164046132
StatusActive
Last updated in NPPESJun 22, 2023
Details
- NPI
- 1164046132
- Entity type
- Organization (NPI-2)
- Legal business name
- Ortho Sport & Spine Physicians Kennesaw
- Organization subpart
- No
- Enumeration date
- Jun 4, 2020
- Certification date
- Jun 22, 2023
- Last updated
- Jun 22, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | – | – | Yes |
| 261QP3300X | Clinic/Center, Pain | – | – |
Practice location
3900 Frey Rd Nw Ste 106Kennesaw, GA 30144-5424
Phone 678-752-7246
Mailing address
5788 Roswell RdAtlanta, GA 30328-4904
Phone 678-752-7246
Other practice locations
4255 Wade Green Rd Nw
Kennesaw, GA 30144-1762
Kennesaw, GA 30144-1762
Phone 678-752-7246
Authorized official
Christopher W Sims
Credentialing Manager
6787527246
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All 7 Physical Medicine & Rehabilitation Physician providers in Kennesaw · All 2,326 providers in Kennesaw
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