Provider Demographics
NPI:1316550064
Name:CHIROPRACTIC CARE OF EAST COBB
Entity Type:Organization
Organization Name:CHIROPRACTIC CARE OF EAST COBB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRENT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BRUMBAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:672-472-6262
Mailing Address - Street 1:198 WINN ST NW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-2256
Mailing Address - Country:US
Mailing Address - Phone:678-472-6262
Mailing Address - Fax:770-428-4956
Practice Address - Street 1:4260 SHALLOWFORD RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-5011
Practice Address - Country:US
Practice Address - Phone:770-998-8599
Practice Address - Fax:770-998-9499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty