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General NPI Number Information
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NPI Number | 1437044484
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Entity Type | Organization
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Legal Business Name | ONE EIGHTY CHIROPRACTIC LLC
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Dates
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Enumeration Date | 06/10/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 3295 RIVER EXCHANGE DR STE 308
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City | NORCROSS
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State | GA
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Zip | 30092-4216
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Country | US
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Telephone | 404-490-2460
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Fax |
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Provider Business Mailing Address
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Address Line | 3450 ROXBORO RD NE APT 4217
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City | ATLANTA
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State | GA
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Zip | 30326-1839
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Country | US
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Telephone | 404-313-6673
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANNE NZEKELLANG MBU ETONGA
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Credential | DC
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Telephone | 404-313-6673
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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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