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General NPI Number Information
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NPI Number | 1831607308
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Entity Type | Organization
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Legal Business Name | BAYLISS CHIROPRACTIC CENTER LLC
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Dates
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Enumeration Date | 01/17/2018
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Last Update Date | 01/17/2018
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Provider Practice Location Address
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Address Line | 11800 NORTHFALL LN STE 1402
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City | ALPHARETTA
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State | GA
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Zip | 30009-7976
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Country | US
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Telephone | 770-580-9294
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Fax |
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Provider Business Mailing Address
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Address Line | 11800 NORTHFALL LN STE 1402
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City | ALPHARETTA
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State | GA
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Zip | 30009-7976
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Country | US
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Telephone | 770-580-9294
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Fax |
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Authorized Official
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Title or Position | CEO/CHIROPRACTOR
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Name | DR. ERIC MICHAEL BAYLISS
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Credential | D.C.
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Telephone | 770-580-9294
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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 | CHIR009996
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License Number State | GA
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