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General NPI Number Information
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NPI Number | 1518041441
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC TRANSFORMATION CENTER
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 08/19/2008
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Provider Practice Location Address
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Address Line | 6600 ROSWELL RD NE SUITE A
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City | ATLANTA
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State | GA
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Zip | 30328-3173
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Country | US
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Telephone | 404-531-0055
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Fax | 404-531-0369
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Provider Business Mailing Address
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Address Line | 6600 ROSWELL RD NE SUITE A
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City | ATLANTA
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State | GA
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Zip | 30328-3173
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Country | US
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Telephone | 404-531-0055
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Fax | 404-531-0369
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Authorized Official
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Title or Position | DOCTOR
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Name | MR. MICHAEL TODD HORTMAN
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Credential | D. C.
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Telephone | 404-531-0055
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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 | CHIR005763
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License Number State | GA
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