MEDICARE: THE CHIRO EXPRESS 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	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1518439066
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CHIRO EXPRESS LLC

Provider Business Mailing Address
First Line	:	3645 MARKETPLACE BLVD # 130-645
Second Line	:
City	:	EAST POINT
State	:	GA
Zip	:	30344-5747
Country	:	US
Telephone Number	:	470-481-1777
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 VIRGINIA AVE STE 302
Second Line	:
City	:	HAPEVILLE
State	:	GA
Zip	:	30354-1367
Country	:	US
Telephone Number	:	470-481-1777
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHRISTOPHER LAMONT BOWE
Credential	:	DC
Telephone Number	:	919-697-6976

Provider Enumeration Date	:	12/21/2018
Last Update Date	:	12/21/2018

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Directions to “THE CHIRO EXPRESS LLC ” Practice Location

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