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General NPI Number Information
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NPI Number | 1578386538
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Entity Type | Organization
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Legal Business Name | ARLISE CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 11/06/2024
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 4900 IVEY RD NW BLDG 800-C
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City | ACWORTH
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State | GA
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Zip | 30101-4001
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Country | US
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Telephone | 678-218-6789
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Fax |
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Provider Business Mailing Address
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Address Line | 302 PARK FOREST CT NW
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City | KENNESAW
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State | GA
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Zip | 30144-1015
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. MICHAEL JENDZURSKI
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Credential | DC
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Telephone | 610-764-7306
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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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