MEDICARE: DR. MICHAEL LOUIS GELLMAN D.C.

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	CHIR005228	GA

General Provider Information

NPI Number	:	1255368916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL LOUIS GELLMAN D.C.

Provider Business Mailing Address
First Line	:	1401 PEACHTREE ST NE
Second Line	:	SUITE 160
City	:	ATLANTA
State	:	GA
Zip	:	30309-3023
Country	:	US
Telephone Number	:	404-475-0386
Fax Number	:	404-475-0443

Provider Business Practice Location Address
First Line	:	1401 PEACHTREE ST NE
Second Line	:	SUITE 160
City	:	ATLANTA
State	:	GA
Zip	:	30309-3023
Country	:	US
Telephone Number	:	404-475-0386
Fax Number	:	404-475-0443

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

Provider Enumeration Date	:	06/27/2006
Last Update Date	:	03/04/2011

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