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General NPI Number Information
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NPI Number | 1114492683
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Entity Type | Organization
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Legal Business Name | PALMERCARE CHIROPRACTIC ATLANTA LLC
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Dates
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Enumeration Date | 10/10/2018
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Last Update Date | 10/10/2018
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Provider Practice Location Address
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Address Line | 2770 LENOX RD NE STE B2
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City | ATLANTA
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State | GA
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Zip | 30324-6006
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Country | US
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Telephone | 202-489-8551
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Fax |
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Provider Business Mailing Address
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Address Line | 2770 LENOX RD NE STE B2
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City | ATLANTA
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State | GA
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Zip | 30324-6006
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Country | US
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Telephone | 202-489-8551
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | CASEY HOLM
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Credential |
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Telephone | 713-829-7506
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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 |
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License Number State |
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