MEDICARE: FAMILY CHIROPRACTIC OFFICE

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	:	1518224997
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY CHIROPRACTIC OFFICE

Provider Business Mailing Address
First Line	:	4343 SHALLOWFORD RD STE 211
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-5041
Country	:	US
Telephone Number	:	678-691-8311
Fax Number	:

Provider Business Practice Location Address
First Line	:	3901 ROSWELL RD
Second Line	:	STE 208
City	:	MARIETTA
State	:	GA
Zip	:	30062-8809
Country	:	US
Telephone Number	:	770-509-9717
Fax Number	:	770-509-8796

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	STEPHANIE TUCKER
Credential	:	DC
Telephone Number	:	678-691-8311

Provider Enumeration Date	:	04/23/2012
Last Update Date	:	05/05/2026

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Directions to “FAMILY CHIROPRACTIC OFFICE ” Practice Location

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