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General NPI Number Information
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NPI Number | 1619102761
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Entity Type | Organization
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Legal Business Name | CLAXTON CHIROPRACTIC LLC
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 01/07/2014
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Provider Practice Location Address
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Address Line | 8 W LIBERTY ST
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City | CLAXTON
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State | GA
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Zip | 30417-2042
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Country | US
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Telephone | 912-739-8311
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Fax | 912-739-8314
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Provider Business Mailing Address
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Address Line | PO BOX 777
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City | CLAXTON
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State | GA
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Zip | 30417-0777
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Country | US
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Telephone | 912-739-8311
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Fax | 912-739-8314
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Authorized Official
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Title or Position | OWNER
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Name | DR. TERRI LYNN NORBURG
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Credential | D.C.
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Telephone | 912-739-8311
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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 | 06080
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License Number State | GA
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