Provider Demographics
NPI:1003957770
Name:ABSOLUTE CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:ABSOLUTE CHIROPRACTIC, INC.
Other - Org Name:ABSOLUTE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-587-5844
Mailing Address - Street 1:10971 CRABAPPLE RD
Mailing Address - Street 2:SUITE 1300
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-5845
Mailing Address - Country:US
Mailing Address - Phone:770-587-5844
Mailing Address - Fax:770-587-5860
Practice Address - Street 1:10971 CRABAPPLE RD
Practice Address - Street 2:SUITE 1300
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-5845
Practice Address - Country:US
Practice Address - Phone:770-587-5844
Practice Address - Fax:770-587-5860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
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
GAGRP3398Medicare ID - Type UnspecifiedMEDICARE B GROUP NUMBER