Healthcare Provider Details

I. General information

NPI: 1316537475
Provider Name (Legal Business Name): ATLANTA CENTER FOR WHOLISTIC CHIROPRACTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2021
Last Update Date: 01/22/2021
Certification Date: 01/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2905 CAMPBELLTON RD SW STE G-H
ATLANTA GA
30311-4511
US

IV. Provider business mailing address

2905 CAMPBELLTON RD SW STE G-H
ATLANTA GA
30311-4511
US

V. Phone/Fax

Practice location:
  • Phone: 404-349-8221
  • Fax: 404-349-5138
Mailing address:
  • Phone: 404-349-8221
  • Fax: 404-349-5138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. CLAYTON E BELL SR.
Title or Position: CEO / OWNER
Credential: D.C., CCEP
Phone: 404-349-8221