| NPI | 1831262914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANETTE ALTIERI Providor Partner 770-513-8922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CHIR004740) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR004727) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2011-11-28 |