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General NPI Number Information
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NPI Number | 1790005403
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Entity Type | Organization
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Legal Business Name | WEST COBB HEALTH ADN REHAB CENTER
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Dates
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Enumeration Date | 06/03/2010
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Last Update Date | 06/03/2010
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Provider Practice Location Address
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Address Line | 3901 MARY ELIZA TRCE NW SUITE 202
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City | MARIETTA
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State | GA
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Zip | 30064-1094
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Country | US
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Telephone | 770-485-3255
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Fax | 770-693-7804
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Provider Business Mailing Address
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Address Line | 3901 MARY ELIZA TRCE NW SUITE 202
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City | MARIETTA
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State | GA
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Zip | 30064-1094
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Country | US
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Telephone | 770-485-3255
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Fax | 770-693-7804
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Authorized Official
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Title or Position | CEO
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Name | DR. CHRISTOPHER JOSEPH CAMPAGNA
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Credential | D.C.
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Telephone | 678-699-3238
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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 | CHIR007533
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License Number State | GA
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