NPI age
19 years
Enumerated 2006-10-12
Across 4970 active chiropractor providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 58-2659125 | FEDERAL TAX ID |
| 01 (GA) | 198-09-00-VL | GEORGIA STATE TAX ID |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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