Healthcare Provider Details

I. General information

NPI: 1992860456
Provider Name (Legal Business Name): HARRY P WARCHOLA DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 HOLLY SPRINGS PKWY SUITE 110
CANTON GA
30115-7429
US

IV. Provider business mailing address

2800 HOLLY SPRINGS PKWY SUITE 110
CANTON GA
30115-7429
US

V. Phone/Fax

Practice location:
  • Phone: 770-345-4551
  • Fax:
Mailing address:
  • Phone: 770-345-4551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number006470
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: