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General NPI Number Information
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NPI Number | 1598891210
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Entity Type | Organization
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Legal Business Name | TURNER BOOTH CLINIC
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5575 MABLETON PKWY SE
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City | MABLETON
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State | GA
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Zip | 30126-3301
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Country | US
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Telephone | 770-944-2300
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Fax | 770-944-7861
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Provider Business Mailing Address
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Address Line | 5575 MABLETON PKWY SE
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City | MABLETON
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State | GA
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Zip | 30126-3301
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Country | US
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Telephone | 770-944-2300
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Fax | 770-944-7861
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | DEBORAH HARNAGE
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Credential |
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Telephone | 770-944-2300
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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 | CHIR001913
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License Number State | GA
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