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General NPI Number Information
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NPI Number | 1801522743
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC SOLUTIONS OF GEORGIA, LLC
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Dates
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Enumeration Date | 07/25/2022
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Last Update Date | 01/22/2024
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Provider Practice Location Address
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Address Line | 610 SHORTER AVE NW STE 9
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City | ROME
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State | GA
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Zip | 30165-4283
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Country | US
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Telephone | 706-290-3229
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 152
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City | ROME
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State | GA
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Zip | 30162-0152
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Country | US
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Telephone | 404-904-5096
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | DR. SHELLI L. DOUGLAS
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Credential | DC
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Telephone | 706-290-3229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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