Healthcare Provider Details

I. General information

NPI: 1154728095
Provider Name (Legal Business Name): STEVEN J ISAACS DC PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2014
Last Update Date: 11/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2453 TOWNE LAKE PKWY
WOODSTOCK GA
30189-5525
US

IV. Provider business mailing address

2453 TOWNE LAKE PKWY
WOODSTOCK GA
30189-5525
US

V. Phone/Fax

Practice location:
  • Phone: 561-715-7013
  • Fax: 770-592-2433
Mailing address:
  • Phone: 561-715-7013
  • Fax: 770-592-2433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH8833
License Number StateGA

VIII. Authorized Official

Name: DR. STEVEN ISAACS
Title or Position: PRESIDENT
Credential: DC
Phone: 561-715-7013