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General NPI Number Information
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NPI Number | 1134642077
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC HEALTHCARE GROUP LLC
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Dates
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Enumeration Date | 07/23/2017
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 777 CLEVELAND AVE SW STE 105
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City | ATLANTA
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State | GA
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Zip | 30315-7119
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Country | US
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Telephone | 470-575-0123
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Fax | 678-649-2135
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Provider Business Mailing Address
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Address Line | 2997 COBB PKWY SE UNIT 723182
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City | ATLANTA
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State | GA
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Zip | 31139-2607
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | DR. DANIEL RIASE
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Credential | DC
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Telephone | 678-649-2131
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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 | CHIR009911
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIR009897
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License Number State | GA
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