MEDICARE: ATLANTA CENTER FOR WHOLISTIC CHIROPRACTIC, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	111NN1001X	Nutrition Chiropractor
2	111NR0400X	Rehabilitation Chiropractor
3	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1316537475
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTA CENTER FOR WHOLISTIC CHIROPRACTIC, INC.

Provider Business Mailing Address
First Line	:	2905 CAMPBELLTON RD SW STE G-H
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30311-4511
Country	:	US
Telephone Number	:	404-349-8221
Fax Number	:	404-349-5138

Provider Business Practice Location Address
First Line	:	2905 CAMPBELLTON RD SW STE G-H
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30311-4511
Country	:	US
Telephone Number	:	404-349-8221
Fax Number	:	404-349-5138

Authorized Official
Title or Position	:	CEO / OWNER
Name	:	DR. CLAYTON E BELL SR.
Credential	:	D.C., CCEP
Telephone Number	:	404-349-8221

Provider Enumeration Date	:	01/22/2021
Last Update Date	:	01/22/2021

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