Provider Demographics
NPI:1518139815
Name:CHIROPRACTIC TOTAL HEALTH CENTER, LLC
Entity Type:Organization
Organization Name:CHIROPRACTIC TOTAL HEALTH CENTER, LLC
Other - Org Name:LINDA L. CRAWFORD D/B/A CHIROPRACTIC TOTAL HEALTH CENTER, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-919-9625
Mailing Address - Street 1:1459 COBB PKWY N
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-2425
Mailing Address - Country:US
Mailing Address - Phone:770-919-9625
Mailing Address - Fax:770-919-8154
Practice Address - Street 1:1459 COBB PKWY N
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-2425
Practice Address - Country:US
Practice Address - Phone:770-919-9625
Practice Address - Fax:770-919-8154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-26
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA002578Medicare PIN