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General NPI Number Information
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NPI Number | 1114069085
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Entity Type | Organization
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Legal Business Name | DUE WEST CHIROPRACTIC AND REHABILITATION LLC
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1600 KENNESAW DUE WEST RD SUITE 501
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City | KENNESAW
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State | GA
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Zip | 30152
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Country | US
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Telephone | 770-429-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 KENNESAW DUE WEST RD SUITE 501
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City | KENNESAW
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State | GA
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Zip | 30152
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Country | US
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Telephone | 770-429-5555
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Fax |
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Authorized Official
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Title or Position | OWNER PARTNER
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Name | DR. ERIC PARTIN
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Credential | D.C.
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Telephone | 770-429-5555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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