MEDICARE: CHIROPRACTIC TOTAL HEALTH CENTER, LLC

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

General Provider Information

NPI Number	:	1518139815
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHIROPRACTIC TOTAL HEALTH CENTER, LLC

Provider Business Mailing Address
First Line	:	1459 COBB PKWY N
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-2425
Country	:	US
Telephone Number	:	770-919-9625
Fax Number	:	770-919-8154

Provider Business Practice Location Address
First Line	:	1459 COBB PKWY N
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-2425
Country	:	US
Telephone Number	:	770-919-9625
Fax Number	:	770-919-8154

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LINDA L. CRAWFORD
Credential	:	D.C.
Telephone Number	:	770-919-9625

Provider Enumeration Date	:	03/26/2008
Last Update Date	:	07/28/2008

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