Healthcare Provider Details

I. General information

NPI: 1346298015
Provider Name (Legal Business Name): SCOTT PERLMAN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 WHITLOCK AVE SW STE. E14
MARIETTA GA
30064-3000
US

IV. Provider business mailing address

707 WHITLOCK AVE SW STE. E14
MARIETTA GA
30064-3000
US

V. Phone/Fax

Practice location:
  • Phone: 678-797-1104
  • Fax: 678-797-1125
Mailing address:
  • Phone: 678-797-1104
  • Fax: 678-797-1125

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number007091
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: