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General NPI Number Information
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NPI Number | 1346401775
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Entity Type | Organization
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Legal Business Name | TAO CHIRO LLC
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Dates
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Enumeration Date | 06/18/2008
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 2545 LAWRENCEVILLE HWY SUITE 100
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City | DECATUR
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State | GA
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Zip | 30033-3239
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Country | US
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Telephone | 404-378-6300
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Fax | 770-939-9353
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Provider Business Mailing Address
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Address Line | 917 SCOTT BLVD
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City | DECATUR
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State | GA
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Zip | 30030-1303
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Country | US
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Telephone | 404-378-8978
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Fax | 770-939-9353
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Authorized Official
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Title or Position | CHIROPRACTOR/REGISTERED NURSE
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Name | DR. JANE ELLEN DINERMAN
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Credential | BSN RN DC
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Telephone | 404-378-6300
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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 | CHIR002592
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License Number State | GA
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