Healthcare Provider Details

I. General information

NPI: 1124946934
Provider Name (Legal Business Name): MARY ELIZABETH SUMMITT DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

972 COLLEGE ST
MONTICELLO GA
31064-2107
US

IV. Provider business mailing address

972 COLLEGE ST
MONTICELLO GA
31064-2107
US

V. Phone/Fax

Practice location:
  • Phone: 706-468-6500
  • Fax: 706-468-5497
Mailing address:
  • Phone: 706-468-6500
  • Fax: 706-468-5497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR066723
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: