Provider Demographics
NPI:1467798124
Name:GALA DAVIS FAMILY CHIROPRACTIC CENTER, P.C.
Entity Type:Organization
Organization Name:GALA DAVIS FAMILY CHIROPRACTIC CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GALA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-486-8777
Mailing Address - Street 1:427 HIGHWAY 74 N
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-1169
Mailing Address - Country:US
Mailing Address - Phone:770-486-8777
Mailing Address - Fax:770-486-0049
Practice Address - Street 1:427 HIGHWAY 74 N
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1169
Practice Address - Country:US
Practice Address - Phone:770-486-8777
Practice Address - Fax:770-486-0049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-27
Last Update Date:2012-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty