A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal...
taxonomy 111N00000X
Identifiers
Type
Value
Notes
01 (GA)
P01084237
PLAN NETWORK ID
01 (GA)
11614811
CAQH
01
CHIR007885
STATE LICENSE
Practice context
Multi-provider organization.
1 individual provider on file at this primary address.
Plus 1 secondary practice location.
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