=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053788612
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LAPOINTE MANAGEMENT SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/29/2015
-----------------------------------------------------
Last Update Date | 08/29/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1102 SMITH AVE STE B
-----------------------------------------------------
City | THOMASVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31792-5700
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 229-226-8755
-----------------------------------------------------
Fax | 229-226-2051
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 2016
-----------------------------------------------------
City | THOMASVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31799-2016
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 229-226-8755
-----------------------------------------------------
Fax | 229-226-2051
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. JAMES MICHAEL CASANOVA
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 229-226-8755
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | 2698
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------