Provider Demographics
NPI:1417151838
Name:RIBLEY FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:RIBLEY FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIRORPACTIC (OWNER)
Authorized Official - Prefix:DR
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RIBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-592-2505
Mailing Address - Street 1:1085 BUCKHEAD XING STE 130
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-4261
Mailing Address - Country:US
Mailing Address - Phone:770-592-2505
Mailing Address - Fax:770-592-2433
Practice Address - Street 1:1085 BUCKHEAD XING STE 130
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-4261
Practice Address - Country:US
Practice Address - Phone:770-592-2505
Practice Address - Fax:770-592-2433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCGJVMedicare ID - Type Unspecified