Provider Demographics
NPI:1508013988
Name:UGELL FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:UGELL FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:W
Authorized Official - Last Name:UGELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-432-5849
Mailing Address - Street 1:1995 WINDY HILL RD SE STE 7
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-2273
Mailing Address - Country:US
Mailing Address - Phone:770-432-5849
Mailing Address - Fax:770-436-5991
Practice Address - Street 1:1995 WINDY HILL RD SE STE 7
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-2273
Practice Address - Country:US
Practice Address - Phone:770-432-5849
Practice Address - Fax:770-436-5991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCCVSMedicare UPIN