Provider Demographics
NPI:1518014265
Name:EATON CHIROPRACTIC CENTER, PC
Entity Type:Organization
Organization Name:EATON CHIROPRACTIC CENTER, PC
Other - Org Name:EATON CHIROPRACTIC WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:EATON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-429-9733
Mailing Address - Street 1:2847 S MAIN ST NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-2748
Mailing Address - Country:US
Mailing Address - Phone:770-429-9733
Mailing Address - Fax:770-429-3208
Practice Address - Street 1:2847 S MAIN ST NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-2748
Practice Address - Country:US
Practice Address - Phone:770-429-9733
Practice Address - Fax:770-429-3208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty