Provider Demographics
NPI:1164111845
Name:PEACHCARE FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:PEACHCARE FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:PRESTON
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:HOLDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:706-733-7577
Mailing Address - Street 1:3106 WRIGHTSBORO RD STE A
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-3043
Mailing Address - Country:US
Mailing Address - Phone:706-733-7577
Mailing Address - Fax:706-733-1940
Practice Address - Street 1:3106 WRIGHTSBORO RD STE A
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-3043
Practice Address - Country:US
Practice Address - Phone:706-733-7577
Practice Address - Fax:706-733-1940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty