SOUTHERN PAIN INSTITUTE PC
Psychiatric at Milstead Rd, Conyers, GA

License number
Georgia 045425
Category
Psychiatric
Type
Interventional Pain Medicine
Owner
Name: ANTHONY T CLAVO SR. MD
Title: CEO
Phone: (770) 632-3730
Address
Address 2
1501 Milstead Rd NE SUITE 140, Conyers, GA 30012
1975 Highway 54 W SUITE 100, Peachtree City, GA 30269
National Provider ID: 1609913318
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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SOUTHERN PAIN INSTITUTE, PC

Fayetteville, GA  -  Peachtree City, GA

Industry:
Medical Doctor's Office
Registration:
Aug 21, 2003
Addresses:
1975 Hwy 54 W, Fayetteville, GA 30214 (Physical)
3200 Shakerag Hl, Peachtree City, GA 30269
State ID:
0346571
Business type:
Domestic Professional Corporation
Office Managers:
T Anthony Clavo (CEO), 1930 W Wesley Rd NW, Atlanta, GA 30327 (Physical),V Lynn Clavo (CFO), 1930 W Wesley Rd NW, Atlanta, GA 30327 (Physical),Lynn Clavo (Pharmacist),...
Agent:
Anthony T. Clavo, Sr., M.d,1930 W Wesley Rd NW, Atlanta, GA (Physical)

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