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General NPI Number Information
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NPI Number | 1750383196
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Entity Type | Organization
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Legal Business Name | FAMILY HEALTHCARE CLINIC, INC.
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Dates
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Enumeration Date | 08/15/2005
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Last Update Date | 11/26/2007
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Provider Practice Location Address
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Address Line | 2768 FIVE FORKS TRICKUM RD
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-5865
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Country | US
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Telephone | 770-978-4419
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Fax | 770-978-2017
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Provider Business Mailing Address
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Address Line | 2768 FIVE FORKS TRICKUM RD
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-5865
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Country | US
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Telephone | 770-978-4419
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Fax | 770-978-2017
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. DEBORAH M BROWN
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Credential | DC
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Telephone | 770-978-4419
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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 | 005294
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License Number State | GA
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