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General NPI Number Information
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NPI Number | 1043426489
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Entity Type | Organization
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Legal Business Name | LAWRENCEVILLE FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 295 W PIKE ST
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City | LAWRENCEVILLE
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State | GA
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Zip | 30045-4877
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Country | US
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Telephone | 678-225-4800
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Fax | 678-225-4801
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Provider Business Mailing Address
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Address Line | 295 W PIKE ST
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City | LAWRENCEVILLE
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State | GA
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Zip | 30045-4877
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Country | US
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Telephone | 678-225-4800
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Fax | 678-225-4801
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEVE L GONINAN
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Credential | DC
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Telephone | 678-225-4800
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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 | 1214500
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License Number State | GA
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