Provider Demographics
NPI:1447419635
Name:STARRETT CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:STARRETT CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:STARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-720-4626
Mailing Address - Street 1:2920 MARIETTA HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-8212
Mailing Address - Country:US
Mailing Address - Phone:770-720-4626
Mailing Address - Fax:
Practice Address - Street 1:2920 MARIETTA HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-8212
Practice Address - Country:US
Practice Address - Phone:770-720-4626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6277111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU77629Medicare UPIN