Provider Demographics
NPI:1518281807
Name:INTEGRITY CHIROPRACTIC
Entity Type:Organization
Organization Name:INTEGRITY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:GONINAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:678-400-0202
Mailing Address - Street 1:11582 CUMMING HWY
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-8123
Mailing Address - Country:US
Mailing Address - Phone:678-400-0202
Mailing Address - Fax:678-400-0232
Practice Address - Street 1:11582 CUMMING HWY
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-8123
Practice Address - Country:US
Practice Address - Phone:678-400-0202
Practice Address - Fax:678-400-0232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-16
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA07151111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty