Healthcare Provider Details

I. General information

NPI: 1982803326
Provider Name (Legal Business Name): HURST CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 08/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 PEACHTREE ST SUITE 160
ATLANTA GA
30309-3023
US

IV. Provider business mailing address

1401 PEACHTREE ST SUITE 160
ATLANTA GA
30309-3023
US

V. Phone/Fax

Practice location:
  • Phone: 404-475-0386
  • Fax: 404-475-0443
Mailing address:
  • Phone: 404-475-0402
  • Fax: 404-475-0443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number008114
License Number StateGA

VIII. Authorized Official

Name: DR. BRADY HURST
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 404-475-0386