Fairview Chiropractic Center, LLC
Clinic/Center in Ellenwood, GA. Organization (NPI-2).
NPI number1598129199
StatusActive
Last updated in NPPESApr 8, 2016
Details
- NPI
- 1598129199
- Entity type
- Organization (NPI-2)
- Legal business name
- Fairview Chiropractic Center, LLC
- Organization subpart
- No
- Enumeration date
- Apr 8, 2016
- Last updated
- Apr 8, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | CHIR06312 | GA | Yes |
Practice location
421 Fairview RdEllenwood, GA 30294-2632
Phone 770-389-1901
Mailing address
421 Fairview RdEllenwood, GA 30294-2632
Phone 770-389-1901
Authorized official
Carol-Ann Elizabeth Cozier-Douglas
President
7703891901
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