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General NPI Number Information
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NPI Number | 1952504334
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Entity Type | Organization
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Legal Business Name | UPPER SPECIFIC
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 344 LUCKIE ST NW
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City | ATLANTA
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State | GA
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Zip | 30313-1724
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Country | US
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Telephone | 404-589-8571
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Fax |
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Provider Business Mailing Address
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Address Line | 344 LUCKIE ST NW
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City | ATLANTA
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State | GA
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Zip | 30313-1724
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Country | US
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Telephone | 404-589-8571
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN S WILLIAMS II
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Credential | DC
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Telephone | 404-589-8571
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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 | CHIR007512
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License Number State | GA
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