Healthcare Provider Details

I. General information

NPI: 1043285505
Provider Name (Legal Business Name): CHANTEL COLMER D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 04/01/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1869 E MAIN ST STE B
HOGANSVILLE GA
30230-2787
US

IV. Provider business mailing address

1869 E MAIN ST STE B
HOGANSVILLE GA
30230-2787
US

V. Phone/Fax

Practice location:
  • Phone: 706-637-1114
  • Fax: 706-637-1124
Mailing address:
  • Phone: 706-637-1114
  • Fax: 706-637-1124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR007362
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number007362
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: