Provider Demographics
NPI:1093088759
Name:ERTLE, JOHN MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:ERTLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 FRANKLIN RD SE STE C
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8005
Mailing Address - Country:US
Mailing Address - Phone:770-951-0080
Mailing Address - Fax:770-980-1500
Practice Address - Street 1:1033 FRANKLIN RD SE STE C
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8005
Practice Address - Country:US
Practice Address - Phone:770-951-0080
Practice Address - Fax:770-980-1500
Is Sole Proprietor?:No
Enumeration Date:2012-02-10
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007644111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation