Provider Demographics
NPI:1043410517
Name:NORTH GEORGIA CHIROPRACTIC
Entity Type:Organization
Organization Name:NORTH GEORGIA CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EARL
Authorized Official - Middle Name:D
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:706-965-5777
Mailing Address - Street 1:PO BOX 1091
Mailing Address - Street 2:
Mailing Address - City:RINGGOLD
Mailing Address - State:GA
Mailing Address - Zip Code:30736-1091
Mailing Address - Country:US
Mailing Address - Phone:706-965-5777
Mailing Address - Fax:706-965-5787
Practice Address - Street 1:29 LEGION ST
Practice Address - Street 2:
Practice Address - City:RINGGOLD
Practice Address - State:GA
Practice Address - Zip Code:30736-2369
Practice Address - Country:US
Practice Address - Phone:706-965-5777
Practice Address - Fax:706-965-5787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6245111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP6553Medicare PIN