| Southside Spinal Center | |
|
386 Racetrack Rd Mcdonough GA 30252-1022 | |
| (678) 583-2982 | |
| (678) 583-2984 |
| Full Name | Southside Spinal Center |
|---|---|
| Speciality | Clinic/center |
| Location | 386 Racetrack Rd, Mcdonough, Georgia |
| Authorized Official Name and Position | Michelle Elizabeth Monasterski-klos (CHIROPRACTOR/OWNER) |
| Authorized Official Contact | 6785832982 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southside Spinal Center 604 Pebble Rd Canton GA 30114-8867 Ph: (678) 697-9667 | Southside Spinal Center 386 Racetrack Rd Mcdonough GA 30252-1022 Ph: (678) 583-2982 |
| NPI Number | 1760717573 |
|---|---|
| Provider Enumeration Date | 10/12/2009 |
| Last Update Date | 09/06/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760717573 | NPI | - | NPPES |
| 202G35640 | Other | GA | MEDICARE OFFICE # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | CHIROO8486 (Georgia) | Primary |
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