MEDICARE: LITTLE RIVER FAMILY CHIROPRACTIC, INC

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	:	1558092346
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LITTLE RIVER FAMILY CHIROPRACTIC, INC

Provider Business Mailing Address
First Line	:	3422 SIXES RD STE 110
Second Line	:
City	:	CANTON
State	:	GA
Zip	:	30114-9120
Country	:	US
Telephone Number	:	336-880-0638
Fax Number	:

Provider Business Practice Location Address
First Line	:	3422 SIXES RD STE 110
Second Line	:
City	:	CANTON
State	:	GA
Zip	:	30114-9120
Country	:	US
Telephone Number	:	770-213-8890
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	STEPHANIE LURATE
Credential	:	DC
Telephone Number	:	336-880-0638

Provider Enumeration Date	:	06/22/2022
Last Update Date	:	02/19/2026

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