MEDICARE: CHAVELLY LAMOLLI DC

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	CHIR010950	GA

General Provider Information

NPI Number	:	1801593512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHAVELLY LAMOLLI DC

Provider Business Mailing Address
First Line	:	7646 SCHOMBURG RD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31909-1816
Country	:	US
Telephone Number	:	706-507-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	4490 CHAMBLEE DUNWOODY RD STE D
Second Line	:
City	:	DUNWOODY
State	:	GA
Zip	:	30338-6259
Country	:	US
Telephone Number	:	770-457-1571
Fax Number	:

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

Provider Enumeration Date	:	02/13/2023
Last Update Date	:	10/30/2023

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Directions to “ CHAVELLY LAMOLLI DC” Practice Location

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