Provider Demographics
NPI:1437463361
Name:BURCH, EUGENE ARTHUR II (DC)
Entity Type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:ARTHUR
Last Name:BURCH
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:MR
Other - First Name:GENO
Other - Middle Name:
Other - Last Name:BURCH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:1806 AUGUSTA DR SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8213
Mailing Address - Country:US
Mailing Address - Phone:678-315-8679
Mailing Address - Fax:
Practice Address - Street 1:5041 DALLAS HWY
Practice Address - Street 2:SUITE 500
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-6458
Practice Address - Country:US
Practice Address - Phone:770-919-7171
Practice Address - Fax:770-218-0341
Is Sole Proprietor?:No
Enumeration Date:2010-08-03
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008694111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor