Healthcare Provider Details

I. General information

NPI: 1053024869
Provider Name (Legal Business Name): SELECT CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2022
Last Update Date: 12/27/2022
Certification Date: 12/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11235 ALPHARETTA HWY STE 130
ROSWELL GA
30076-1460
US

IV. Provider business mailing address

11235 ALPHARETTA HWY STE 130
ROSWELL GA
30076-1460
US

V. Phone/Fax

Practice location:
  • Phone: 678-878-3134
  • Fax: 404-738-1452
Mailing address:
  • Phone: 788-783-1346
  • Fax: 404-738-1452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. DEAN ACHESON R MELTINORD
Title or Position: OWNER
Credential: DC
Phone: 404-618-7766