Provider Demographics
NPI:1518090513
Name:HEWETT-MCNEIL FAMILY CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:HEWETT-MCNEIL FAMILY CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MALISSIA
Authorized Official - Middle Name:F
Authorized Official - Last Name:HEWETT-MCNEIL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-489-0002
Mailing Address - Street 1:PO BOX 2006
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30133-2006
Mailing Address - Country:US
Mailing Address - Phone:678-715-3131
Mailing Address - Fax:
Practice Address - Street 1:8303 B OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134
Practice Address - Country:US
Practice Address - Phone:678-715-3131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty