| NPI | 1609064716 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WILLIAM PROCTOR President 770-383-9605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CHIROOO514) |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2007-10-15 |