Healthcare Provider Details

I. General information

NPI: 1831492461
Provider Name (Legal Business Name): FIDELITY HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2010
Last Update Date: 09/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 SPRING ST NW SUITE 150
ATLANTA GA
30309-2846
US

IV. Provider business mailing address

1100 SPRING ST NW SUITE 150
ATLANTA GA
30309-2846
US

V. Phone/Fax

Practice location:
  • Phone: 404-815-1505
  • Fax: 404-815-1669
Mailing address:
  • Phone: 404-815-1505
  • Fax: 404-815-1669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. CLEVE TAYLOR
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 404-815-1505