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General NPI Number Information
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NPI Number | 1518295617
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Entity Type | Organization
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Legal Business Name | TRIDENT OF GEORGIA CHIROPRACTIC AND WELLNESS CENTER, INC
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Dates
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Enumeration Date | 12/01/2009
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Last Update Date | 01/24/2012
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Provider Practice Location Address
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Address Line | 3029 DEANS BRIDGE RD
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City | AUGUSTA
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State | GA
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Zip | 30906-2921
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Country | US
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Telephone | 706-793-0141
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Fax | 706-798-7912
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Provider Business Mailing Address
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Address Line | 3029 DEANS BRIDGE RD
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City | AUGUSTA
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State | GA
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Zip | 30906-2921
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Country | US
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Telephone | 706-793-0141
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Fax | 706-798-7912
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Authorized Official
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Title or Position | OWNER
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Name | DR. SCOTT E SHERMAN SR.
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Credential | D.C.
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Telephone | 706-793-0141
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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 | CHIR001767
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License Number State | GA
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