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General NPI Number Information
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NPI Number | 1215516075
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Entity Type | Organization
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Legal Business Name | EMBRACE CHIROPRACTIC CENTER PC
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Dates
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Enumeration Date | 04/07/2021
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Last Update Date | 04/22/2021
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Provider Practice Location Address
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Address Line | 4411 SUWANEE DAM RD STE 635
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City | SUWANEE
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State | GA
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Zip | 30024-8708
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Country | US
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Telephone | 770-765-3884
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Fax |
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Provider Business Mailing Address
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Address Line | 4411 SUWANEE DAM RD STE 635
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City | SUWANEE
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State | GA
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Zip | 30024-8708
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Country | US
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Telephone | 770-765-3884
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | SHAKIRA LEE
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Credential |
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Telephone | 770-765-3884
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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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