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General NPI Number Information
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NPI Number | 1205134384
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Entity Type | Organization
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Legal Business Name | BERES CHIROPRACTIC CENTER, INC
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Dates
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Enumeration Date | 03/14/2011
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Last Update Date | 03/14/2011
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Provider Practice Location Address
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Address Line | 2263 BROOKSTONE CENTRE PKWY SUITE B
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City | COLUMBUS
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State | GA
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Zip | 31904-4649
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Country | US
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Telephone | 770-468-4213
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Fax |
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Provider Business Mailing Address
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Address Line | 142 AUTUMN TRAIL WAY
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City | WAVERLY HALL
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State | GA
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Zip | 31831-2457
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Country | US
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Telephone | 770-468-4213
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Fax | 706-582-3339
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES MICHAEL BERES II
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Credential | D.C.
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Telephone | 770-468-4213
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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 | CHIRO08678
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License Number State | GA
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