Healthcare Provider Details

I. General information

NPI: 1982873857
Provider Name (Legal Business Name): ZONE HEALING CENTER-ATLANTA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2008
Last Update Date: 02/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 MONROE DR NE SUITE C-206
ATLANTA GA
30308-1793
US

IV. Provider business mailing address

931 MONROE DR NE SUITE C-206
ATLANTA GA
30308-1793
US

V. Phone/Fax

Practice location:
  • Phone: 404-587-0871
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License NumberCHIR008298
License Number StateGA

VIII. Authorized Official

Name: DR. EDWARD HURST PEACOCK
Title or Position: CO-OWNER
Credential: D.C.
Phone: 404-587-0871