Provider Demographics
NPI:1235515958
Name:WHOLE BODY CONCEPT CHIROPRATIC
Entity Type:Organization
Organization Name:WHOLE BODY CONCEPT CHIROPRATIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ACRE
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:678-392-6867
Mailing Address - Street 1:4150 SNAPFINGER WOODS DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-3417
Mailing Address - Country:US
Mailing Address - Phone:678-392-6867
Mailing Address - Fax:855-218-7881
Practice Address - Street 1:4150 SNAPFINGER WOODS DR
Practice Address - Street 2:SUITE 210
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-3417
Practice Address - Country:US
Practice Address - Phone:678-392-6867
Practice Address - Fax:855-218-7881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008778111N00000X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty