MEDICARE: DR. PHILIP A LIBRONE D.C.

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	005549	GA

General Provider Information

NPI Number	:	1669551842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PHILIP A LIBRONE D.C.

Provider Business Mailing Address
First Line	:	1685 MARS HILL RD NW STE 103
Second Line	:
City	:	ACWORTH
State	:	GA
Zip	:	30101-7180
Country	:	US
Telephone Number	:	770-218-0400
Fax Number	:	770-218-1160

Provider Business Practice Location Address
First Line	:	1685 MARS HILL RD NW STE 103
Second Line	:
City	:	ACWORTH
State	:	GA
Zip	:	30101-7180
Country	:	US
Telephone Number	:	770-218-0400
Fax Number	:	770-218-1160

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. PHILIP A LIBRONE D.C.” Practice Location

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