Healthcare Provider Details

I. General information

NPI: 1487830253
Provider Name (Legal Business Name): A HEALING PLACE CHIROPRACTIC CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2008
Last Update Date: 01/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 PEACHTREE PKWY #230
CUMMING GA
30041-7228
US

IV. Provider business mailing address

415 PEACHTREE PKWY #230
CUMMING GA
30041-7228
US

V. Phone/Fax

Practice location:
  • Phone: 678-947-3316
  • Fax: 678-947-3317
Mailing address:
  • Phone: 678-947-3316
  • Fax: 678-947-3317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIRO08276
License Number StateGA

VIII. Authorized Official

Name: DR. NOVA ANN GRANDE
Title or Position: DOCTOR
Credential: DC DOCTOR OF CHIROPR
Phone: 678-947-3316