Healthcare Provider Details

I. General information

NPI: 1013435478
Provider Name (Legal Business Name): RAINBOW CITY CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2017
Last Update Date: 09/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3155 ROSWELL RD NE STE 140
ATLANTA GA
30305-1836
US

IV. Provider business mailing address

3046 MOSER WAY
MARIETTA GA
30060-6340
US

V. Phone/Fax

Practice location:
  • Phone: 678-571-2595
  • Fax:
Mailing address:
  • Phone: 678-571-2595
  • Fax: 678-668-2492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR008202
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberCHIR008202
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License NumberCHIR008202
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code111NR0200X
TaxonomyRadiology Chiropractor
License NumberCHIR008202
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberCHIR008202
License Number StateGA
# 6
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberCHIR008202
License Number StateGA

VIII. Authorized Official

Name: DR. ARTHUR LEE MATTHEWS III
Title or Position: OWNER
Credential: DC
Phone: 678-571-2595