Provider Demographics
NPI:1477632974
Name:LEVINSON CHIROPRACTIC CENTER INC
Entity Type:Organization
Organization Name:LEVINSON CHIROPRACTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HELENE
Authorized Official - Middle Name:F
Authorized Official - Last Name:LEVINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-257-0404
Mailing Address - Street 1:5457 ROSWELL RD NE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1900
Mailing Address - Country:US
Mailing Address - Phone:404-257-0404
Mailing Address - Fax:404-257-0351
Practice Address - Street 1:5457 ROSWELL RD NE
Practice Address - Street 2:SUITE 102
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1900
Practice Address - Country:US
Practice Address - Phone:404-257-0404
Practice Address - Fax:404-257-0351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR003027111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00845402AMedicaid
GA35ZCCMCMedicare ID - Type UnspecifiedMR #
GAU18299Medicare UPIN