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General NPI Number Information
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NPI Number | 1982904306
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Entity Type | Organization
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Legal Business Name | BRAIN AND BODY SOLUTIONS, LLC
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Dates
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Enumeration Date | 11/01/2010
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Last Update Date | 11/03/2010
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Provider Practice Location Address
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Address Line | 675 SEMINOLE AVE NE STE T-05
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City | ATLANTA
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State | GA
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Zip | 30307-3408
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Country | US
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Telephone | 404-755-9233
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Fax |
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Provider Business Mailing Address
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Address Line | 675 SEMINOLE AVE NE STE T-05
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City | ATLANTA
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State | GA
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Zip | 30307-3408
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Country | US
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Telephone | 404-755-9233
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | STEPHANIE J RIMKA
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Credential | DC
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Telephone | 404-755-9233
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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 | CHIR006915
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License Number State | GA
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