MEDICARE: BORN CHIROPRACTIC AND MASSAGE STUDIO

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	CHIR004737	GA

General Provider Information

NPI Number	:	1326368879
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BORN CHIROPRACTIC AND MASSAGE STUDIO

Provider Business Mailing Address
First Line	:	1776 PEACHTREE ST NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-2307
Country	:	US
Telephone Number	:	404-408-0143
Fax Number	:

Provider Business Practice Location Address
First Line	:	1776 PEACHTREE ST NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-2307
Country	:	US
Telephone Number	:	404-408-0143
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERATOR
Name	:	THOMAS JAMES BORN
Credential	:	D.C.
Telephone Number	:	404-408-0143

Provider Enumeration Date	:	06/07/2010
Last Update Date	:	06/07/2010

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