Provider Demographics
NPI:1326211137
Name:ALPHARETTA PROADJUSTER WELLNESS CENTER
Entity Type:Organization
Organization Name:ALPHARETTA PROADJUSTER WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:FAHEEM
Authorized Official - Middle Name:
Authorized Official - Last Name:NASIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-630-2882
Mailing Address - Street 1:11205 ALPHARETTA HWY
Mailing Address - Street 2:A6
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-5610
Mailing Address - Country:US
Mailing Address - Phone:770-442-9978
Mailing Address - Fax:
Practice Address - Street 1:11205 ALPHARETTA HWY
Practice Address - Street 2:A6
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5610
Practice Address - Country:US
Practice Address - Phone:770-442-9978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-12
Last Update Date:2008-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008044111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty