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General NPI Number Information
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NPI Number | 1619551314
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Entity Type | Organization
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Legal Business Name | STONE HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 05/09/2021
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Last Update Date | 05/09/2021
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Provider Practice Location Address
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Address Line | 953 PORT WEST DR
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City | AUBURN
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State | GA
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Zip | 30011-4607
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Country | US
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Telephone | 678-595-4320
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Fax |
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Provider Business Mailing Address
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Address Line | 953 PORT WEST DR
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City | AUBURN
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State | GA
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Zip | 30011-4607
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. KELLY BOHAN
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Credential | DC
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Telephone | 678-595-4320
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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 |
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License Number State |
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