Healthcare Provider Details

I. General information

NPI: 1922307073
Provider Name (Legal Business Name): COURTNEY ACREE D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2011
Last Update Date: 12/31/2020
Certification Date: 12/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3636 PANOLA RD STE B
STONECREST GA
30038-2792
US

IV. Provider business mailing address

3904 N DRUID HILLS RD # 177
DECATUR GA
30033-3105
US

V. Phone/Fax

Practice location:
  • Phone: 770-733-1381
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIRO8778
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: