Healthcare Provider Details

I. General information

NPI: 1972699601
Provider Name (Legal Business Name): SOUTHMETRO CHIROPRACTIC CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7202 TARA BLVD
JONESBORO GA
30236-1902
US

IV. Provider business mailing address

7202 TARA BLVD
JONESBORO GA
30236-1902
US

V. Phone/Fax

Practice location:
  • Phone: 770-472-8989
  • Fax: 770-472-8969
Mailing address:
  • Phone: 770-472-8989
  • Fax: 770-472-8969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number2067
License Number StateGA

VIII. Authorized Official

Name: DR. ROBERT ALPERT
Title or Position: CEO
Credential: D.C.
Phone: 770-472-8989