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General NPI Number Information
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NPI Number | 1033637533
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Entity Type | Organization
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Legal Business Name | ONE HUNDRED PERCENT CHIROPRACTIC ATLANTA EIGHT
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Dates
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Enumeration Date | 09/05/2017
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Last Update Date | 09/05/2017
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Provider Practice Location Address
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Address Line | 4490 CHAMBLEE DUNWOODY RD STE D
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City | ATLANTA
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State | GA
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Zip | 30338-6237
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Country | US
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Telephone | 770-457-1571
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Fax | 770-457-1571
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Provider Business Mailing Address
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Address Line | 4516 HUNTERS WAY
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City | STONE MOUNTAIN
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State | GA
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Zip | 30083-2553
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Country | US
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Telephone | 404-536-4267
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. TWILA BLOSSOM JONES
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Credential | DC
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Telephone | 404-919-4545
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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 | CHIR009842
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License Number State | GA
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