MEDICARE: DR. CEDRICK CHRISTOPHER NOEL

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	111NN1001X	Nutrition Chiropractor	CHIR007222	GA

General Provider Information

NPI Number	:	1285629253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CEDRICK CHRISTOPHER NOEL

Provider Business Mailing Address
First Line	:	10930 CRABAPPLE RD
Second Line	:	STE 18
City	:	ROSWELL
State	:	GA
Zip	:	30075-5813
Country	:	US
Telephone Number	:	770-587-2280
Fax Number	:	770-587-2286

Provider Business Practice Location Address
First Line	:	10930 CRABAPPLE RD
Second Line	:
City	:	ROSWELL
State	:	GA
Zip	:	30075-5812
Country	:	US
Telephone Number	:	770-587-2280
Fax Number	:	770-587-2286

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

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	07/08/2007

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