Provider Demographics
NPI:1134310303
Name:ADVANCED CHIROPRACTIC SOLUTIONS, L.L.C.
Entity Type:Organization
Organization Name:ADVANCED CHIROPRACTIC SOLUTIONS, L.L.C.
Other - Org Name:ADVANCED CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-574-5005
Mailing Address - Street 1:145 HEAD AVE
Mailing Address - Street 2:
Mailing Address - City:TALLAPOOSA
Mailing Address - State:GA
Mailing Address - Zip Code:30176-1260
Mailing Address - Country:US
Mailing Address - Phone:770-574-5005
Mailing Address - Fax:770-574-5006
Practice Address - Street 1:145 HEAD AVE
Practice Address - Street 2:
Practice Address - City:TALLAPOOSA
Practice Address - State:GA
Practice Address - Zip Code:30176-1260
Practice Address - Country:US
Practice Address - Phone:770-574-5005
Practice Address - Fax:770-574-5006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007205111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty