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General NPI Number Information
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NPI Number | 1912049479
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Entity Type | Organization
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Legal Business Name | KENLEY CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3528 OLD MILTON PKWY
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City | ALPHARETTA
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State | GA
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Zip | 30005-4459
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Country | US
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Telephone | 770-772-7333
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Fax | 770-772-1664
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Provider Business Mailing Address
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Address Line | 3528 OLD MILTON PKWY
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City | ALPHARETTA
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State | GA
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Zip | 30005-4459
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Country | US
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Telephone | 770-772-7333
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Fax | 770-772-1664
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. GREGG MICHAEL BLOTNER
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Credential | D.C.
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Telephone | 770-772-7333
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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 | CHIR006571
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License Number State | GA
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