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General NPI Number Information
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NPI Number | 1720571466
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Entity Type | Organization
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Legal Business Name | DUKE HEALTH AND WELLNESS
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Dates
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Enumeration Date | 06/07/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 1455 BELLS FERRY RD STE 200
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City | MARIETTA
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State | GA
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Zip | 30066-6078
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Country | US
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Telephone | 770-693-0707
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Fax | 770-693-0930
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Provider Business Mailing Address
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Address Line | PO BOX 3514
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City | MARIETTA
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State | GA
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Zip | 30061-3514
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Country | US
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Telephone | 770-693-0707
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Fax | 770-693-0930
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Authorized Official
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Title or Position | CLINIC DIRECTOR/ AO
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Name | DR. JOHN THOMAS DUKE
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Credential | DC
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Telephone | 770-693-0707
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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 | GA0005676
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License Number State | GA
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