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General NPI Number Information
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NPI Number | 1164690715
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Entity Type | Organization
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Legal Business Name | AMERICAN CHIROPRACTIC SPECIALISTS, INC.
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Dates
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Enumeration Date | 02/18/2008
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Last Update Date | 11/13/2017
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Provider Practice Location Address
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Address Line | 113 CARL VINSON PKWY SUITE A
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City | WARNER ROBINS
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State | GA
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Zip | 31088-5817
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Country | US
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Telephone | 478-960-9943
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Fax |
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Provider Business Mailing Address
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Address Line | 113 CARL VINSON PKWY
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City | WARNER ROBINS
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State | GA
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Zip | 31088-5817
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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 | PRESIDENT/OWNER
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Name | KELLY J LAW
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Credential |
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Telephone | 478-225-9840
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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 | CHIR007902
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License Number State | GA
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