Provider Demographics
NPI:1588967848
Name:GEORGIA INJURY & SPINE CENTER OF MORROW
Entity type:Organization
Organization Name:GEORGIA INJURY & SPINE CENTER OF MORROW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:C
Authorized Official - Last Name:SILVESTRO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-217-3809
Mailing Address - Street 1:7147 JONESBORO RD
Mailing Address - Street 2:SUITE J
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260-2954
Mailing Address - Country:US
Mailing Address - Phone:770-961-2474
Mailing Address - Fax:
Practice Address - Street 1:7147 JONESBORO RD
Practice Address - Street 2:SUITE J
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-2954
Practice Address - Country:US
Practice Address - Phone:770-961-2474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0059432083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Single Specialty