Healthcare Provider Details

I. General information

NPI: 1184561102
Provider Name (Legal Business Name): THE CHI RHO COLLECTIVE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3312 NORTHSIDE DR STE A150
MACON GA
31210-0450
US

IV. Provider business mailing address

3312 NORTHSIDE DR STE A150
MACON GA
31210-0450
US

V. Phone/Fax

Practice location:
  • Phone: 478-219-7468
  • Fax: 478-219-7321
Mailing address:
  • Phone: 478-219-7468
  • Fax: 478-219-7321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: BRANDI LAWANE PUGH
Title or Position: OWNER/PRACTITIONER
Credential: DC
Phone: 478-731-9387