Provider Demographics
NPI:1245562537
Name:CBT & ASSOCIATES, INC
Entity Type:Organization
Organization Name:CBT & ASSOCIATES, INC
Other - Org Name:MARIETTA SQUARE CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WURST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-424-6222
Mailing Address - Street 1:152 ROSWELL ST SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1945
Mailing Address - Country:US
Mailing Address - Phone:770-424-6222
Mailing Address - Fax:770-424-6789
Practice Address - Street 1:152 ROSWELL ST SE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1945
Practice Address - Country:US
Practice Address - Phone:770-424-6222
Practice Address - Fax:770-424-6789
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CBT & ASSOCIATES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-11
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2670111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA58-1796239Medicare UPIN