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General NPI Number Information
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NPI Number | 1023310638
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Entity Type | Organization
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Legal Business Name | GEORGIA INJURY & SPINE CENTER OF DECATUR
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Dates
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Enumeration Date | 12/02/2010
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Last Update Date | 12/02/2010
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Provider Practice Location Address
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Address Line | 2417 CANDLER RD
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City | DECATUR
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State | GA
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Zip | 30032-6410
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Country | US
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Telephone | 404-284-0888
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Fax |
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Provider Business Mailing Address
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Address Line | 2417 CANDLER RD
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City | DECATUR
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State | GA
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Zip | 30032-6410
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Country | US
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Telephone | 404-284-0888
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MATTHEW C SILVESTRO
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Credential | DC
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Telephone | 404-217-3809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083X0100X
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Taxonomy Name | Occupational Medicine Physician
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License Number | 005943
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License Number State | GA
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