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General NPI Number Information
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NPI Number | 1487283180
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Entity Type | Organization
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Legal Business Name | LEMONADE CHIROPRACTIC LLC.
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Dates
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Enumeration Date | 04/04/2020
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Last Update Date | 04/04/2020
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Provider Practice Location Address
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Address Line | 2118 MAIN ST E
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City | SNELLVILLE
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State | GA
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Zip | 30078-3496
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Country | US
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Telephone | 770-343-7473
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Fax | 470-552-3863
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Provider Business Mailing Address
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Address Line | 7672 BROADHURST DR
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City | RIVERDALE
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State | GA
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Zip | 30296-7167
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Country | US
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Telephone | 404-337-3024
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Fax |
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. DIONNE ANDERSON
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Credential | DC
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Telephone | 404-337-3024
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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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