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NPI Code Detail

MEDICARE: MAXLIVING NORCROSS LLC

MEDICARE: MAXLIVING NORCROSS 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
1111N00000XChiropractor

General Provider Information

NPI Number : 1831044932
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAXLIVING NORCROSS LLC
Provider Business Mailing Address
First Line : 1568 INDIAN TRAIL LILBURN RD STE 105
Second Line :
City : NORCROSS
State : GA
Zip : 30093-2699
Country : US
Telephone Number : 770-696-2404
Fax Number :
Provider Business Practice Location Address
First Line : 1568 INDIAN TRAIL LILBURN RD STE 105
Second Line :
City : NORCROSS
State : GA
Zip : 30093-2699
Country : US
Telephone Number : 770-696-2404
Fax Number :
Authorized Official
Title or Position : OWNER/PROVIDER
Name : DR. STEPHENIE DALLAS
Credential : DC
Telephone Number : 770-696-2404
Provider Enumeration Date : 03/03/2026
Last Update Date : 03/03/2026

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Directions to “MAXLIVING NORCROSS LLC ” Practice Location

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