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General NPI Number Information
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NPI Number | 1457721730
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Entity Type | Organization
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Legal Business Name | CHIROCHOICE OF DALTON LLC
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Dates
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Enumeration Date | 09/30/2015
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 1508 N THORNTON AVE STE 104
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City | DALTON
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State | GA
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Zip | 30720-8516
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Country | US
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Telephone | 706-279-9295
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Fax | 706-279-9296
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Provider Business Mailing Address
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Address Line | 1508 N THORNTON AVE STE 104
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City | DALTON
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State | GA
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Zip | 30720-8516
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Country | US
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Telephone | 706-279-9295
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Fax | 706-279-9296
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Authorized Official
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Title or Position | OWNER/ATTENDING PHYSICIAN
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Name | DR. TIMOTHY SCOTT MANIS
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Credential | DC
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Telephone | 706-279-9295
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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 | 2627
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License Number State | GA
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