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General NPI Number Information
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NPI Number | 1710004999
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Entity Type | Organization
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Legal Business Name | DECATUR PAIN & REHAB
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 01/14/2009
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Provider Practice Location Address
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Address Line | 3755 MEMORIAL DR STE A
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City | DECATUR
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State | GA
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Zip | 30032-2253
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Country | US
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Telephone | 404-534-6606
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Fax | 404-534-6602
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Provider Business Mailing Address
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Address Line | 3755 MEMORIAL DR STE A
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City | DECATUR
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State | GA
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Zip | 30032-2253
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Country | US
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Telephone | 404-534-6606
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Fax | 404-534-6602
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Authorized Official
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Title or Position | CHIROPRACTIC
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Name | DR. KAREN S ISAACSON
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Credential | DC
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Telephone | 404-534-6606
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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 | CHIR006296
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License Number State | GA
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