Provider Demographics
NPI:1114069085
Name:DUE WEST CHIROPRACTIC AND REHABILITATION LLC
Entity Type:Organization
Organization Name:DUE WEST CHIROPRACTIC AND REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:PARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-429-5555
Mailing Address - Street 1:1600 KENNESAW DUE WEST RD
Mailing Address - Street 2:SUITE 501
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152
Mailing Address - Country:US
Mailing Address - Phone:770-429-5555
Mailing Address - Fax:
Practice Address - Street 1:1600 KENNESAW DUE WEST RD
Practice Address - Street 2:SUITE 501
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152
Practice Address - Country:US
Practice Address - Phone:770-429-5555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty