MEDICARE: MISS CHRIS D BRAGG 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	006779	GA

General Provider Information

NPI Number	:	1396844403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CHRIS D BRAGG D.C

Provider Business Mailing Address
First Line	:	4445 PINEWALK DR
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30022-7079
Country	:	US
Telephone Number	:	678-867-9604
Fax Number	:

Provider Business Practice Location Address
First Line	:	8610 ROSWELL RD
Second Line	:	SUITE 750
City	:	ATLANTA
State	:	GA
Zip	:	30350-7534
Country	:	US
Telephone Number	:	770-998-1678
Fax Number	:	770-587-1679

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

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	07/08/2007

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