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: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3312 NORTHSIDE DR STE A155
MACON GA
31210-0471
US

IV. Provider business mailing address

102 FORMOSA WALK
MACON GA
31206-5221
US

V. Phone/Fax

Practice location:
  • Phone: 478-731-9387
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: BRANDI L PUGH
Title or Position: CHIROPRACTOR
Credential: MAT, DC
Phone: 478-731-9387