Healthcare Provider Details

I. General information

NPI: 1780366088
Provider Name (Legal Business Name): MEMBERS CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2023
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4343 SHALLOWFORD RD STE 160
MARIETTA GA
30062-5075
US

IV. Provider business mailing address

3605 SANDY PLAINS RD STE 240-262
MARIETTA GA
30066-3068
US

V. Phone/Fax

Practice location:
  • Phone: 770-649-1730
  • Fax:
Mailing address:
  • Phone: 770-649-1730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICK J CRISS
Title or Position: OWNER
Credential: DC
Phone: 770-649-1730