MEDICARE: DR. EMILY MAUMUS WHYNOT DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CHIR010161	GA

General Provider Information

NPI Number	:	1134898562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMILY MAUMUS WHYNOT DC

Provider Business Mailing Address
First Line	:	2617 WILLOW GROVE RD NW
Second Line	:
City	:	ACWORTH
State	:	GA
Zip	:	30101-3029
Country	:	US
Telephone Number	:	678-523-0705
Fax Number	:

Provider Business Practice Location Address
First Line	:	2617 WILLOW GROVE RD NW
Second Line	:
City	:	ACWORTH
State	:	GA
Zip	:	30101-3029
Country	:	US
Telephone Number	:	678-523-0705
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2021
Last Update Date	:	09/09/2021

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