Provider Demographics
NPI:1508925140
Name:FALITE, MICHAEL JOHN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOHN
Last Name:FALITE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 VAUGHAN DR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-7511
Mailing Address - Country:US
Mailing Address - Phone:770-667-2232
Mailing Address - Fax:
Practice Address - Street 1:2910 VAUGHAN DR
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7511
Practice Address - Country:US
Practice Address - Phone:770-667-2232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2014-07-23
Deactivation Date:2014-02-11
Deactivation Code:
Reactivation Date:2014-07-23
Provider Licenses
StateLicense IDTaxonomies
GA62131111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor