Healthcare Provider Details

I. General information

NPI: 1831335041
Provider Name (Legal Business Name): LAUREN KAY LOUIS D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2008
Last Update Date: 12/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5680 GLEN ERROL RD NW
ATLANTA GA
30327-4854
US

IV. Provider business mailing address

5680 GLEN ERROL RD NW
ATLANTA GA
30327-4854
US

V. Phone/Fax

Practice location:
  • Phone: 404-735-1292
  • Fax: 404-497-0528
Mailing address:
  • Phone: 404-735-1292
  • Fax: 404-497-0528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number5065
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: