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General NPI Number Information
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NPI Number | 1407374150
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Entity Type | Organization
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Legal Business Name | FEHMEL FAMILY CHIROPRACTIC LLC
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Dates
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Enumeration Date | 09/01/2017
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Last Update Date | 09/28/2017
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Provider Practice Location Address
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Address Line | 635 GREEN ST NW
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City | GAINESVILLE
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State | GA
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Zip | 30501-3319
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Country | US
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Telephone | 678-450-1570
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Fax |
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Provider Business Mailing Address
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Address Line | 7309 LAZY HAMMOCK WAY
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City | FLOWERY BRANCH
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State | GA
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Zip | 30542-7730
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Country | US
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Telephone | 912-659-4787
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. MICHELLE MARIAM FEHMEL
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Credential | DC
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Telephone | 912-659-4787
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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 | CHIR007630
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License Number State | GA
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