Provider Demographics
NPI:1467754085
Name:CHIROPRACTIC SOULUTION, LLC
Entity Type:Organization
Organization Name:CHIROPRACTIC SOULUTION, LLC
Other - Org Name:WEST POINT FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENTON
Authorized Official - Middle Name:COE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:706-645-1033
Mailing Address - Street 1:PO BOX 142
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30241-0003
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1106 3RD AVE
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:GA
Practice Address - Zip Code:31833-1218
Practice Address - Country:US
Practice Address - Phone:706-645-1033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008086111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty