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General NPI Number Information
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NPI Number | 1801099726
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Entity Type | Organization
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Legal Business Name | HEALTH CONCEPTS
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 12/20/2007
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Provider Practice Location Address
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Address Line | 560 N JEFF DAVIS DR
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-1665
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Country | US
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Telephone | 770-719-8785
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Fax |
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Provider Business Mailing Address
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Address Line | 560 N JEFF DAVIS DR
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-1665
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JANIQUE COOK
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Credential |
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Telephone | 770-719-8785
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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 | 07386
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 08061
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 01554
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License Number State | GA
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