| NPI | 1043495427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ROCHE Office Manager 404-363-6460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CHIR002353) |
| Additional Taxonomies | 208D00000X General Practice (Licence: GA 047279) |
| Enumeration Date | 2008-01-04 |
| Last Update Date | 2008-01-04 |