Provider Demographics
NPI:1043583438
Name:ONCALL MOBILE CHIROPRACTIC L.L.C.
Entity Type:Organization
Organization Name:ONCALL MOBILE CHIROPRACTIC L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:AXON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-881-0203
Mailing Address - Street 1:1620 PARK SHORE DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-8654
Mailing Address - Country:US
Mailing Address - Phone:770-881-0203
Mailing Address - Fax:770-886-9771
Practice Address - Street 1:1620 PARK SHORE DR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-8654
Practice Address - Country:US
Practice Address - Phone:770-881-0203
Practice Address - Fax:770-886-9771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-15
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006211111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCFNKMedicare UPIN