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General NPI Number Information
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NPI Number | 1518014265
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Entity Type | Organization
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Legal Business Name | EATON CHIROPRACTIC CENTER, PC
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 10/02/2008
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Provider Practice Location Address
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Address Line | 2847 S MAIN ST NW
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City | KENNESAW
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State | GA
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Zip | 30144-2748
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Country | US
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Telephone | 770-429-9733
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Fax | 770-429-3208
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Provider Business Mailing Address
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Address Line | 2847 S MAIN ST NW
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City | KENNESAW
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State | GA
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Zip | 30144-2748
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Country | US
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Telephone | 770-429-9733
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Fax | 770-429-3208
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Authorized Official
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Title or Position | CEO
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Name | DR. JIM EATON
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Credential | DC
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Telephone | 770-429-9733
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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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