Healthcare Provider Details

I. General information

NPI: 1205418233
Provider Name (Legal Business Name): JOSEPH FORESE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2021
Last Update Date: 04/28/2021
Certification Date: 04/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 BARCLAY CIR SE
MARIETTA GA
30060-2943
US

IV. Provider business mailing address

722 IROQUOIS DR NE
MARIETTA GA
30060-1227
US

V. Phone/Fax

Practice location:
  • Phone: 770-426-2786
  • Fax: 770-792-6113
Mailing address:
  • Phone: 706-968-8840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR007433
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: