Healthcare Provider Details

I. General information

NPI: 1942519566
Provider Name (Legal Business Name): LIBERTY COUNTY CLINIC OF CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2010
Last Update Date: 05/09/2023
Certification Date: 05/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 E MEMORIAL DR
HINESVILLE GA
31313-2709
US

IV. Provider business mailing address

211 E MEMORIAL DR
HINESVILLE GA
31313-2709
US

V. Phone/Fax

Practice location:
  • Phone: 912-368-0002
  • Fax: 912-368-4009
Mailing address:
  • Phone: 912-368-0002
  • Fax: 912-368-4009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberCHIR008717
License Number StateGA

VIII. Authorized Official

Name: DR. DAVID L PEER
Title or Position: PRES
Credential: DC
Phone: 912-368-4002