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General NPI Number Information
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NPI Number | 1548523723
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Entity Type | Organization
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Legal Business Name | INJURY RELIEF CHIROPRACTIC
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Dates
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Enumeration Date | 06/21/2012
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Last Update Date | 06/14/2013
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Provider Practice Location Address
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Address Line | 6223 OAKDALE RIDGE CT SE
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City | MABLETON
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State | GA
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Zip | 30126-2921
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Country | US
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Telephone | 678-710-3073
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Fax | 678-501-5174
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Provider Business Mailing Address
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Address Line | 6223 OAKDALE RIDGE CT SE
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City | MABLETON
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State | GA
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Zip | 30126-2921
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Country | US
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Telephone | 678-710-3073
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Fax | 678-501-5174
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. EVELYN FLEMONS
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Credential |
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Telephone | 404-697-9597
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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 | CHIR008767
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License Number State | GA
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