=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699920983
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DR. BIGGS CHIROPRACTIC, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/01/2008
-----------------------------------------------------
Last Update Date | 12/01/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 736 JOHNSON FERRY RD. SUITE -C130
-----------------------------------------------------
City | MARIETTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30068-4233
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-469-5635
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | P.O. BOX 7896
-----------------------------------------------------
City | MARIETTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30065-9998
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-469-5635
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIROPRACTOR
-----------------------------------------------------
Name | LEABA LASHAY BIGGS
-----------------------------------------------------
Credential | D.C.
-----------------------------------------------------
Telephone | 678-469-5635
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number | CHIR008020
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------