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General NPI Number Information
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NPI Number | 1225309909
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Entity Type | Organization
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Legal Business Name | EMORY CHIROPRACTIC CLINIC, LLC
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Dates
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Enumeration Date | 01/26/2012
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Last Update Date | 01/26/2012
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Provider Practice Location Address
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Address Line | 1670 MCKENDREE CHURCH RD BLDG: 400 B
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-4107
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Country | US
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Telephone | 678-667-1670
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Fax |
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Provider Business Mailing Address
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Address Line | 1670 MCKENDREE CHURCH RD BLDG: 400 B
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-4107
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Country | US
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Telephone | 678-667-1670
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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. KAMLESH RAMJI PATEL
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Credential | D.C.
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Telephone | 678-667-1670
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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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Taxonomy #2
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number |
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License Number State |
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