Provider Demographics
NPI:1114253119
Name:WELL ADJUSTED CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:WELL ADJUSTED CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NADINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUEDIRI
Authorized Official - Suffix:
Authorized Official - Credentials:DC,
Authorized Official - Phone:404-384-2417
Mailing Address - Street 1:102 MARSH HARBOUR PKWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:KINGSLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31548-6754
Mailing Address - Country:US
Mailing Address - Phone:404-384-2417
Mailing Address - Fax:
Practice Address - Street 1:102 MARSH HARBOUR PKWY
Practice Address - Street 2:SUITE 102
Practice Address - City:KINGSLAND
Practice Address - State:GA
Practice Address - Zip Code:31548-6754
Practice Address - Country:US
Practice Address - Phone:404-384-2417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008475111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty