| NPI | 1689610529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARISSA JANINE GANNAN Doctor/Partner 706-548-5922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA chir007885) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2020-08-22 |