=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922270453
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEALTHFIRST FAMILY CHIROPRACTIC, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/25/2008
-----------------------------------------------------
Last Update Date | 03/25/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1580 MARS HILL RD SUITE B
-----------------------------------------------------
City | WATKINSVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30677-4836
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-769-9009
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1580 MARS HILL RD SUITE B
-----------------------------------------------------
City | WATKINSVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30677-4836
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-769-9009
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | D.C./PRESIDENT
-----------------------------------------------------
Name | JEANETTE MARIE HIEBER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 706-769-9009
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CHIRO007191
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------