Provider Demographics
NPI:1467658377
Name:CHIROPRACTIC HEALING CENTER
Entity Type:Organization
Organization Name:CHIROPRACTIC HEALING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RENNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAMPI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-926-0123
Mailing Address - Street 1:114 TOWNE LAKE PKWY
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-4843
Mailing Address - Country:US
Mailing Address - Phone:770-926-0123
Mailing Address - Fax:
Practice Address - Street 1:114 TOWNE LAKE PKWY
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-4843
Practice Address - Country:US
Practice Address - Phone:770-926-0123
Practice Address - Fax:770-926-0123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO05993111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU69608Medicare UPIN
GA35ZCHXLMedicare PIN