Provider Demographics
NPI:1487830253
Name:A HEALING PLACE CHIROPRACTIC CENTER INC
Entity Type:Organization
Organization Name:A HEALING PLACE CHIROPRACTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NOVA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GRANDE
Authorized Official - Suffix:
Authorized Official - Credentials:DC DOCTOR OF CHIROPR
Authorized Official - Phone:678-947-3316
Mailing Address - Street 1:415 PEACHTREE PKWY
Mailing Address - Street 2:#230
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-7228
Mailing Address - Country:US
Mailing Address - Phone:678-947-3316
Mailing Address - Fax:678-947-3317
Practice Address - Street 1:415 PEACHTREE PKWY
Practice Address - Street 2:#230
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7228
Practice Address - Country:US
Practice Address - Phone:678-947-3316
Practice Address - Fax:678-947-3317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO08276111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty