Pine Mountain Chiropractic Center, LLC
Clinic/Center, Health Services in Pine Mountain, GA. Organization (NPI-2).
NPI number1023201217
StatusActive
Last updated in NPPESAug 22, 2007
Details
- NPI
- 1023201217
- Entity type
- Organization (NPI-2)
- Legal business name
- Pine Mountain Chiropractic Center, LLC
- Organization subpart
- No
- Enumeration date
- Aug 22, 2007
- Last updated
- Aug 22, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QH0100X | Clinic/Center, Health Services | 2301000RN | GA | Yes |
Practice location
624 N Main AvePine Mountain, GA 31822-2403
Phone 706-663-8801
Mailing address
624 N Main AveP.O. Box 1690
Pine Mountain, GA 31822-2403
Phone 706-663-8801
Authorized official
Kim W. Russell
Office Manager
7066638801
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