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General NPI Number Information
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NPI Number | 1619295532
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Entity Type | Organization
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Legal Business Name | NORTHWEST CHIROPRACTIC
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Dates
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Enumeration Date | 05/17/2010
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Last Update Date | 05/17/2010
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Provider Practice Location Address
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Address Line | 1526 HOWELL MILL RD NW
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City | ATLANTA
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State | GA
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Zip | 30318-7651
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Country | US
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Telephone | 404-350-0808
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Fax | 404-350-0530
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Provider Business Mailing Address
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Address Line | 1526 HOWELL MILL RD NW
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City | ATLANTA
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State | GA
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Zip | 30318-7651
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Country | US
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Telephone | 404-350-0808
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Fax | 404-350-0530
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | LEANA KART
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Credential | DC
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Telephone | 404-350-0808
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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 | CHIR002958
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License Number State | GA
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