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General NPI Number Information
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NPI Number | 1497934301
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Entity Type | Organization
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Legal Business Name | BACK IN ACTION HEALTH AND WELLNESS LLC
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Dates
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Enumeration Date | 10/26/2007
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Last Update Date | 10/26/2007
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Provider Practice Location Address
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Address Line | 2201 SANDRIDGE PL SW
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City | ATLANTA
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State | GA
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Zip | 30331-8447
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Country | US
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Telephone | 770-639-1082
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Fax | 404-629-2943
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Provider Business Mailing Address
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Address Line | 2201 SANDRIDGE PL SW
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City | ATLANTA
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State | GA
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Zip | 30331-8447
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Country | US
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Telephone | 770-639-1082
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Fax | 404-629-2943
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. GEORGE THOMAS FREEMAN JR.
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Credential | D.C.
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Telephone | 770-639-1082
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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 | CHIR007900
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License Number State | GA
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