Provider Demographics
NPI:1346431186
Name:ABSOLUTE CHIROPRACTIC AND WELLNESS, LLC
Entity Type:Organization
Organization Name:ABSOLUTE CHIROPRACTIC AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:JAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:678-461-3512
Mailing Address - Street 1:45 W CROSSVILLE RD
Mailing Address - Street 2:STE 503
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-2964
Mailing Address - Country:US
Mailing Address - Phone:678-461-3512
Mailing Address - Fax:678-461-3513
Practice Address - Street 1:45 W CROSSVILLE RD
Practice Address - Street 2:STE 503
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-2964
Practice Address - Country:US
Practice Address - Phone:678-461-3512
Practice Address - Fax:678-461-3513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty