Healthcare Provider Details

I. General information

NPI: 1154427086
Provider Name (Legal Business Name): CHIROPRACTIC CENTER OF ROME PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 REDMOND RD NW
ROME GA
30165-1538
US

IV. Provider business mailing address

210 REDMOND RD NW
ROME GA
30165-1538
US

V. Phone/Fax

Practice location:
  • Phone: 706-234-8221
  • Fax: 706-291-9647
Mailing address:
  • Phone: 706-234-8221
  • Fax: 706-291-9647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES C. NELSON
Title or Position: OWNER/DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 706-234-8221