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General NPI Number Information
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NPI Number | 1336423409
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Entity Type | Organization
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Legal Business Name | BALANCED FAMILY WELLNESS
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Dates
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Enumeration Date | 10/06/2011
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Last Update Date | 02/06/2019
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Provider Practice Location Address
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Address Line | 931 LOWER FAYETTEVILLE RD STE H
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City | NEWNAN
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State | GA
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Zip | 30263-5790
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Country | US
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Telephone | 706-683-6884
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Fax | 770-252-5630
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Provider Business Mailing Address
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Address Line | 931 LOWER FAYETTEVILLE RD STE H
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City | NEWNAN
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State | GA
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Zip | 30263-5790
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Country | US
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Telephone | 404-936-8546
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Fax | 770-252-5630
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JENNIFER ANN MCGEHEE
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Credential | D.C
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Telephone | 770-683-6884
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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 | CHIR008708
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License Number State | GA
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