Prospine Wellness & Injury Care PC
Chiropractor in Kennesaw, GA. Organization (NPI-2).
NPI number1194357046
StatusActive
Last updated in NPPESFeb 9, 2020
Details
- NPI
- 1194357046
- Entity type
- Organization (NPI-2)
- Legal business name
- Prospine Wellness & Injury Care PC
- Organization subpart
- No
- Enumeration date
- Feb 9, 2020
- Certification date
- Feb 9, 2020
- Last updated
- Feb 9, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | – | – | Yes |
Practice location
4200 Wade Green Rd Nw Ste 204Kennesaw, GA 30144-1808
Phone 602-430-6994
Mailing address
3430 Harris Farms WayAustell, GA 30106-8017
Phone 602-430-6994
Authorized official
Raymond D Taylor
President
6024306994
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