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General NPI Number Information
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NPI Number | 1962557520
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Entity Type | Organization
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Legal Business Name | SPINAL HEALTH SOLUTIONS, LLC
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3545 PEACHTREE INDUSTRIAL BLVD
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City | DULUTH
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State | GA
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Zip | 30096-8063
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Country | US
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Telephone | 678-584-9775
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2920
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City | DULUTH
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State | GA
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Zip | 30096-0050
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Country | US
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Telephone | 678-584-9775
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Fax | 678-584-2245
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Authorized Official
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Title or Position | MEMBER
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Name | ERIC M FREEDMAN
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Credential | DC
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Telephone | 678-584-9775
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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 | CHIR007451
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License Number State | GA
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