Healthcare Provider Details

I. General information

NPI: 1831540236
Provider Name (Legal Business Name): UPPER CERVICAL HEALTH SOLUTIONS LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2016
Last Update Date: 06/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 COMMERCE PARK DR SE SUITE 115
MARIETTA GA
30060-2741
US

IV. Provider business mailing address

PO BOX 4786
MARIETTA GA
30061-4786
US

V. Phone/Fax

Practice location:
  • Phone: 770-792-0002
  • Fax:
Mailing address:
  • Phone: 770-792-0002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number5684
License Number StateGA

VIII. Authorized Official

Name: DR. DAVID T GADSDEN
Title or Position: C.E.O
Credential: D.C.
Phone: 770-792-0002