MEDICARE: ADDYS CABANAS PC

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	2877	GA

General Provider Information

NPI Number	:	1598800955
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADDYS CABANAS PC

Provider Business Mailing Address
First Line	:	2 LENOX POINTE NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-3167
Country	:	US
Telephone Number	:	404-261-7877
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 LENOX POINTE NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-3167
Country	:	US
Telephone Number	:	404-261-7877
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. SUSAN A POWELL
Credential	:
Telephone Number	:	404-261-7877

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	07/18/2008

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Directions to “ADDYS CABANAS PC ” Practice Location

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