Healthcare Provider Details

I. General information

NPI: 1386551968
Provider Name (Legal Business Name): THE CHIRO PLACE COLLECTIVE - DOUGLASVILLE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 CHAPEL HILL RD STE 1200
DOUGLASVILLE GA
30135-4238
US

IV. Provider business mailing address

4300 CHAPEL HILL RD STE 1200
DOUGLASVILLE GA
30135-4238
US

V. Phone/Fax

Practice location:
  • Phone: 678-403-2865
  • Fax:
Mailing address:
  • Phone: 678-403-2865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DENA GRANGER
Title or Position: OWNER
Credential:
Phone: 678-403-2865