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General NPI Number Information
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NPI Number | 1225891385
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Entity Type | Organization
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Legal Business Name | REDD CHIROPRACTIC & WELLNESS LLC
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Dates
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Enumeration Date | 02/01/2024
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Last Update Date | 02/01/2024
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Provider Practice Location Address
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Address Line | 127 CHURCH ST NE
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City | MARIETTA
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State | GA
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Zip | 30060-8637
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Country | US
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Telephone | 614-769-3752
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Fax |
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Provider Business Mailing Address
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Address Line | 100 SENNA ST
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City | MARIETTA
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State | GA
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Zip | 30064-4415
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Country | US
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Telephone | 614-769-3752
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR/ OWNER
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Name | STEPHANIE MARIE REDD
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Credential | DC
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Telephone | 614-769-3752
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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