Healthcare Provider Details

I. General information

NPI: 1003489972
Provider Name (Legal Business Name): 100 CHIRO ROWLAND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2021
Last Update Date: 07/20/2021
Certification Date: 07/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 PEACHTREE PKWY
CUMMING GA
30041-4801
US

IV. Provider business mailing address

515 PEACHTREE PKWY
CUMMING GA
30041-4801
US

V. Phone/Fax

Practice location:
  • Phone: 404-780-9448
  • Fax:
Mailing address:
  • Phone: 404-780-9448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: MR. DANIEL R ROWLAND
Title or Position: OWNER
Credential:
Phone: 404-780-9448