Provider Demographics
NPI:1154656635
Name:MAXIMUM LIFE HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:MAXIMUM LIFE HEALTH CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAX
Authorized Official - Middle Name:A
Authorized Official - Last Name:HOROWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-923-7966
Mailing Address - Street 1:5385 FIVE FORKS TRICKUM RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-3018
Mailing Address - Country:US
Mailing Address - Phone:770-923-7966
Mailing Address - Fax:770-923-6191
Practice Address - Street 1:5385 FIVE FORKS TRICKUM RD
Practice Address - Street 2:SUITE F
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-3018
Practice Address - Country:US
Practice Address - Phone:770-923-7966
Practice Address - Fax:770-923-6191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO07890111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty