MEDICARE: GADD CHIROPRACTIC CLINIC 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	CHIRO01017	GA

General Provider Information

NPI Number	:	1760648737
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GADD CHIROPRACTIC CLINIC PC

Provider Business Mailing Address
First Line	:	3047 BATTLEFIELD PKWY
Second Line	:
City	:	FT OGLETHORPE
State	:	GA
Zip	:	30742-4003
Country	:	US
Telephone Number	:	706-866-4553
Fax Number	:	706-866-8348

Provider Business Practice Location Address
First Line	:	3047 BATTLEFIELD PKWY
Second Line	:
City	:	FT OGLETHORPE
State	:	GA
Zip	:	30742-4003
Country	:	US
Telephone Number	:	706-866-4553
Fax Number	:	706-866-8348

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICHARD E GADD
Credential	:	D.C.
Telephone Number	:	706-866-4553

Provider Enumeration Date	:	07/30/2008
Last Update Date	:	07/30/2008

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