Healthcare Provider Details

I. General information

NPI: 1043410517
Provider Name (Legal Business Name): NORTH GEORGIA CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2007
Last Update Date: 04/12/2023
Certification Date: 04/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 LEGION ST
RINGGOLD GA
30736-2369
US

IV. Provider business mailing address

PO BOX 1091
RINGGOLD GA
30736-1091
US

V. Phone/Fax

Practice location:
  • Phone: 706-965-5777
  • Fax: 706-965-5787
Mailing address:
  • Phone: 706-965-5777
  • Fax: 706-965-5787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number6245
License Number StateGA

VIII. Authorized Official

Name: EARL D SMITH
Title or Position: PRESIDENT
Credential: D.C.
Phone: 706-965-5777