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General NPI Number Information
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NPI Number | 1912340670
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Entity Type | Organization
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Legal Business Name | S. I. T. E. HEALTHCARE, INC
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Dates
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Enumeration Date | 04/12/2013
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Last Update Date | 04/12/2013
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Provider Practice Location Address
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Address Line | 2790 SANDY PLAINS RD STE. 201
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City | MARIETTA
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State | GA
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Zip | 30066-4373
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Country | US
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Telephone | 770-565-8151
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Fax | 770-565-8151
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Provider Business Mailing Address
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Address Line | 2790 SANDY PLAINS RD STE. 201
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City | MARIETTA
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State | GA
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Zip | 30066-4373
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Country | US
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Telephone | 770-565-8151
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Fax | 770-565-8151
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Authorized Official
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Title or Position | OWNER
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Name | DR. RALPH GERVASIO SCHIPSKE
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Credential | D.C.
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Telephone | 770-565-8151
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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 | CHIR007482
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License Number State | GA
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