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General NPI Number Information
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NPI Number | 1902977457
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Entity Type | Organization
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Legal Business Name | LIGHT FORCE FAMILY CHIROPRACTIC PC
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 06/11/2013
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Provider Practice Location Address
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Address Line | 680 DUNLAP RD NE
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City | MILLEDGEVILLE
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State | GA
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Zip | 31061-5405
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Country | US
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Telephone | 478-452-5433
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Fax | 478-454-1929
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Provider Business Mailing Address
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Address Line | 680 DUNLAP RD NE
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City | MILLEDGEVILLE
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State | GA
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Zip | 31061-5405
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Country | US
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Telephone | 478-452-5433
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Fax | 478-454-1929
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHERRY A MEEKS
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Credential | DC
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Telephone | 478-452-5433
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 2139643AH
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License Number State | GA
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