=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194421487
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEARTS CALL CHIROPRACTIC MINISTRIES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/07/2023
-----------------------------------------------------
Last Update Date | 02/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 582 GROVE ST N STE B
-----------------------------------------------------
City | DAHLONEGA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30533-0349
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-867-7015
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 582 GROVE ST N STE B
-----------------------------------------------------
City | DAHLONEGA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30533-0349
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-867-7015
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. ELISSA BARNETT
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 706-867-7015
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------