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NPI Code Detail

MEDICARE: BUCKHEAD CHIROPRACTIC GROUP

MEDICARE: BUCKHEAD CHIROPRACTIC GROUP
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
1111N00000XChiropractor008263GA

General Provider Information

NPI Number : 1871741439
Entity Type Code : Organization
Provider Name (Legal Business Name) : BUCKHEAD CHIROPRACTIC GROUP
Provider Business Mailing Address
First Line : 1316 RED HILL RD
Second Line :
City : MARIETTA
State : GA
Zip : 30008-5302
Country : US
Telephone Number : 404-455-4804
Fax Number :
Provider Business Practice Location Address
First Line : 3155 ROSWELL RD NE STE 140
Second Line :
City : ATLANTA
State : GA
Zip : 30305-1836
Country : US
Telephone Number : 404-455-4804
Fax Number : 404-231-5546
Authorized Official
Title or Position : CHIROPRACTOR
Name : DR. ELTON DARRELL HOLDEN
Credential : D.C.
Telephone Number : 404-455-4804
Provider Enumeration Date : 09/08/2008
Last Update Date : 09/08/2008

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Directions to “BUCKHEAD CHIROPRACTIC GROUP ” Practice Location

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