Organization Name: | WELLNESS ONE OF SUWANEE |
NPI Number: | 1124243704 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DANIEL LYNN MIDDLETON (BILLING MANAGER) |
Mailing Address: | 1500 Peachtree Industrial Blvd Suite 290 Suwanee |
State: | GA US |
Postal Code: | 30024 |
Phone Number: | 6784827375 |
Fax Number: | |
NPI Enumeration Date: | 04/17/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | CHIRO008139 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | GA |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |