MEDICARE: UGELL FAMILY CHIROPRACTIC

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

General Provider Information

NPI Number	:	1508013988
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UGELL FAMILY CHIROPRACTIC

Provider Business Mailing Address
First Line	:	1995 WINDY HILL RD SE STE 7
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30080-2273
Country	:	US
Telephone Number	:	770-432-5849
Fax Number	:	770-436-5991

Provider Business Practice Location Address
First Line	:	1995 WINDY HILL RD SE STE 7
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30080-2273
Country	:	US
Telephone Number	:	770-432-5849
Fax Number	:	770-436-5991

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. MARC W UGELL
Credential	:
Telephone Number	:	770-432-5849

Provider Enumeration Date	:	08/27/2008
Last Update Date	:	08/27/2008

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Directions to “UGELL FAMILY CHIROPRACTIC ” Practice Location

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