Provider Demographics
NPI:1003835224
Name:ARROWHEAD CLINIC, INC.
Entity Type:Organization
Organization Name:ARROWHEAD CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:W
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:SR
Authorized Official - Credentials:DC
Authorized Official - Phone:770-961-5577
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30237-0069
Mailing Address - Country:US
Mailing Address - Phone:770-961-5577
Mailing Address - Fax:770-961-1407
Practice Address - Street 1:750 MOUNT ZION RD
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-3002
Practice Address - Country:US
Practice Address - Phone:770-961-5577
Practice Address - Fax:770-961-1407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP1288Medicare ID - Type UnspecifiedGROUP NUMBER