Provider Demographics
NPI:1245807577
Name:PICMAN, CHASE (DC)
Entity Type:Individual
Prefix:
First Name:CHASE
Middle Name:
Last Name:PICMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 POWERS FERRY RD SE UNIT 1462
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5167
Mailing Address - Country:US
Mailing Address - Phone:419-528-9931
Mailing Address - Fax:
Practice Address - Street 1:131 ROSWELL ST STE 101B
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-1909
Practice Address - Country:US
Practice Address - Phone:770-558-6580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010539111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor