Healthcare Provider Details

I. General information

NPI: 1114797750
Provider Name (Legal Business Name): AIM CHIROPRACTIC & FITNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

2900 DELK RD SE STE 17
MARIETTA GA
30067-5320
US

IV. Provider business mailing address

2900 DELK RD SE STE 17
MARIETTA GA
30067-5320
US

V. Phone/Fax

Practice location:
  • Phone: 770-672-0541
  • Fax: 770-672-0848
Mailing address:
  • Phone: 770-672-0541
  • Fax: 770-672-0848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. STEPHANIE LOUISE SMITH
Title or Position: OWNER/DOCOTOR
Credential: DC
Phone: 770-672-0541