Provider Demographics
NPI:1225309909
Name:EMORY CHIROPRACTIC CLINIC, LLC
Entity Type:Organization
Organization Name:EMORY CHIROPRACTIC CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMLESH
Authorized Official - Middle Name:RAMJI
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:678-667-1670
Mailing Address - Street 1:1670 MCKENDREE CHURCH RD
Mailing Address - Street 2:BLDG: 400 B
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-4107
Mailing Address - Country:US
Mailing Address - Phone:678-667-1670
Mailing Address - Fax:
Practice Address - Street 1:1670 MCKENDREE CHURCH RD
Practice Address - Street 2:BLDG: 400 B
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-4107
Practice Address - Country:US
Practice Address - Phone:678-667-1670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty