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General NPI Number Information
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NPI Number | 1609270420
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Entity Type | Organization
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Legal Business Name | FREEDOM FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 10/22/2014
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Last Update Date | 04/22/2015
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Provider Practice Location Address
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Address Line | 3370 LAWRENCEVILLE SUWANEE RD SUITE 118
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City | SUWANEE
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State | GA
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Zip | 30024-6569
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Country | US
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Telephone | 404-576-8020
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Fax |
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Provider Business Mailing Address
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Address Line | 3370 LAWRENCEVILLE SUWANEE RD SUITE 118
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City | SUWANEE
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State | GA
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Zip | 30024-6569
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Country | US
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Telephone | 404-576-8020
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | MRS. JENNIFER SUE WOZNIAK
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Credential | DC
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Telephone | 404-576-8020
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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 | CHIRO09354
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License Number State | GA
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