MEDICARE: DR. JOHN RODNEY JUSTICE D.C.

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	111N00000X	Chiropractor	1438	GA

General Provider Information

NPI Number	:	1275677544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN RODNEY JUSTICE D.C.

Provider Business Mailing Address
First Line	:	PO BOX 2353
Second Line	:
City	:	PEACHTREE CITY
State	:	GA
Zip	:	30269-0353
Country	:	US
Telephone Number	:	770-487-5600
Fax Number	:	770-487-4914

Provider Business Practice Location Address
First Line	:	1999 HIGHWAY 54 W
Second Line	:
City	:	FAYETTEVILLE
State	:	GA
Zip	:	30214-4747
Country	:	US
Telephone Number	:	770-487-5600
Fax Number	:	770-487-4911

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2007
Last Update Date	:	07/08/2007

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