MEDICARE: MCMULLEN CHIROPRACTIC, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1013859560
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCMULLEN CHIROPRACTIC, LLC

Provider Business Mailing Address
First Line	:	744 SCOUT DR
Second Line	:
City	:	ACWORTH
State	:	GA
Zip	:	30102-1757
Country	:	US
Telephone Number	:	203-605-5096
Fax Number	:	678-884-0291

Provider Business Practice Location Address
First Line	:	1301 SHILOH RD NW
Second Line	:
City	:	KENNESAW
State	:	GA
Zip	:	30144-7147
Country	:	US
Telephone Number	:	678-884-0291
Fax Number	:	678-884-0291

Authorized Official
Title or Position	:	ORGANIZER
Name	:	NICHOLAS BENGE MCMULLEN
Credential	:	DC
Telephone Number	:	203-605-5096

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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