MEDICARE: CH'I CHIROPRACTIC WELLNESS CENTER, LLC

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	CHIR008498	GA

General Provider Information

NPI Number	:	1760715080
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CH'I CHIROPRACTIC WELLNESS CENTER, LLC

Provider Business Mailing Address
First Line	:	2153 MILLENNIUM WAY NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30319-4044
Country	:	US
Telephone Number	:	404-593-5798
Fax Number	:	678-799-7267

Provider Business Practice Location Address
First Line	:	3720 CHAMBLEE DUNWOODY RD STE C&D
Second Line	:
City	:	CHAMBLEE
State	:	GA
Zip	:	30341-2064
Country	:	US
Telephone Number	:	404-593-5798
Fax Number	:	678-799-7267

Authorized Official
Title or Position	:	OWNER/MEMBER
Name	:	DR. CRYSTAL DAWN BROWN
Credential	:	D.C.
Telephone Number	:	404-593-5798

Provider Enumeration Date	:	09/18/2009
Last Update Date	:	09/18/2009

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