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General NPI Number Information
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NPI Number | 1598800955
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Entity Type | Organization
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Legal Business Name | ADDYS CABANAS PC
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 07/18/2008
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Provider Practice Location Address
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Address Line | 2 LENOX POINTE NE
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City | ATLANTA
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State | GA
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Zip | 30324-3167
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Country | US
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Telephone | 404-261-7877
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Fax |
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Provider Business Mailing Address
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Address Line | 2 LENOX POINTE NE
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City | ATLANTA
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State | GA
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Zip | 30324-3167
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Country | US
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Telephone | 404-261-7877
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. SUSAN A POWELL
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Credential |
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Telephone | 404-261-7877
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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 | 2877
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License Number State | GA
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