Provider Demographics
NPI:1205867470
Name:ADLER FAMILY CHIROPRACTIC PC
Entity Type:Organization
Organization Name:ADLER FAMILY CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:ADLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-594-2233
Mailing Address - Street 1:1475 HOLCOMB BRIDGE RD
Mailing Address - Street 2:SUITE 177
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-2139
Mailing Address - Country:US
Mailing Address - Phone:770-594-2233
Mailing Address - Fax:770-594-1080
Practice Address - Street 1:1475 HOLCOMB BRIDGE RD
Practice Address - Street 2:SUITE 177
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-2126
Practice Address - Country:US
Practice Address - Phone:770-594-2233
Practice Address - Fax:770-594-1080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR004666111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACHIR004666OtherSTATE LISCENSE
GAGRP6589OtherGROUP