Healthcare Provider Details

I. General information

NPI: 1225653256
Provider Name (Legal Business Name): CODY FEBLES DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2020
Last Update Date: 01/20/2021
Certification Date: 01/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15800 BIRMINGHAM HWY STE 500
MILTON GA
30004-4423
US

IV. Provider business mailing address

15800 BIRMINGHAM HWY STE 500
MILTON GA
30004-4423
US

V. Phone/Fax

Practice location:
  • Phone: 678-266-3300
  • Fax: 678-266-3322
Mailing address:
  • Phone: 678-266-3300
  • Fax: 678-266-3322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR010372
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: