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General NPI Number Information
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NPI Number | 1003097767
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Entity Type | Organization
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Legal Business Name | SHERWOOD CHIROPRACTIC CENTER
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Dates
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Enumeration Date | 11/21/2007
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Last Update Date | 11/21/2007
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Provider Practice Location Address
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Address Line | 1275 MCCONNELL DR SUITE E
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City | DECATUR
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State | GA
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Zip | 30033-3505
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Country | US
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Telephone | 404-321-0082
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Fax | 404-321-2007
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Provider Business Mailing Address
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Address Line | 1275 MCCONNELL DR SUITE E
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City | DECATUR
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State | GA
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Zip | 30033-3505
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Country | US
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Telephone | 404-321-0082
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Fax | 404-321-2007
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Authorized Official
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Title or Position | INSURANCE EXPERT
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Name | MARILYN DENISE THOMAS
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Credential |
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Telephone | 404-321-6997
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIRO05269
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License Number State | GA
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