Healthcare Provider Details

I. General information

NPI: 1760673321
Provider Name (Legal Business Name): CHAMBLEE CHIROPRACTIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

4005 BUFORD HWY NE STE K
ATLANTA GA
30345-1628
US

IV. Provider business mailing address

4005 BUFORD HWY NE STE K
ATLANTA GA
30345-1628
US

V. Phone/Fax

Practice location:
  • Phone: 404-634-8000
  • Fax: 404-634-8808
Mailing address:
  • Phone: 404-634-8000
  • Fax: 404-634-8808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberCHIR004863
License Number StateGA

VIII. Authorized Official

Name: DR. ROBERT J ZARACH
Title or Position: OWNER
Credential: D.C.
Phone: 404-634-8000