Provider Demographics
NPI:1073952123
Name:WHOLE BODY MEDICAL LLC
Entity Type:Organization
Organization Name:WHOLE BODY MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GECKLER
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:706-867-8086
Mailing Address - Street 1:PO BOX 456
Mailing Address - Street 2:
Mailing Address - City:DAHLONEGA
Mailing Address - State:GA
Mailing Address - Zip Code:30533-0008
Mailing Address - Country:US
Mailing Address - Phone:706-867-8086
Mailing Address - Fax:770-807-0597
Practice Address - Street 1:86 YONAH VW
Practice Address - Street 2:
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533-2011
Practice Address - Country:US
Practice Address - Phone:706-867-8086
Practice Address - Fax:770-807-0597
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHEROKEE GOLD INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-06-21
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service