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General NPI Number Information
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NPI Number | 1568836278
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Entity Type | Organization
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Legal Business Name | GEORGIA ADVANCED HEALTHCARE, LLC
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Dates
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Enumeration Date | 11/18/2015
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 3049 MARIETTA HWY STE 120
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City | CANTON
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State | GA
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Zip | 30114-4286
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Country | US
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Telephone | 678-880-7576
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Fax | 678-348-7177
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Provider Business Mailing Address
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Address Line | 3049 MARIETTA HWY STE 120
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City | CANTON
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State | GA
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Zip | 30114-4286
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Country | US
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Telephone | 678-880-7576
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Fax | 678-348-7177
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Authorized Official
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Title or Position | OWNER/CEO
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Name | WILLIAM PAUL EARLY
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Credential |
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Telephone | 678-880-7576
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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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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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