Provider Demographics
NPI:1073732046
Name:BEAROR FAMILY CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:BEAROR FAMILY CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:NATHAN
Authorized Official - Last Name:BEAROR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:678-585-9956
Mailing Address - Street 1:885 WOODSTOCK RD
Mailing Address - Street 2:SUITE 705
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-2277
Mailing Address - Country:US
Mailing Address - Phone:678-585-9956
Mailing Address - Fax:678-585-9957
Practice Address - Street 1:885 WOODSTOCK RD
Practice Address - Street 2:SUITE 705
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-2277
Practice Address - Country:US
Practice Address - Phone:678-585-9956
Practice Address - Fax:678-585-9957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO06673111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty