Provider Demographics
NPI:1518455450
Name:BUILDING BACK ESSENTIALS (BBE) CHIROPRACTIC AND WELLNESS
Entity Type:Organization
Organization Name:BUILDING BACK ESSENTIALS (BBE) CHIROPRACTIC AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHAFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-500-7913
Mailing Address - Street 1:2451 CUMBERLAND PKWY SE STE 3730
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-6136
Mailing Address - Country:US
Mailing Address - Phone:404-500-7913
Mailing Address - Fax:912-550-4883
Practice Address - Street 1:1600 ROSWELL ST SE STE 11
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-2227
Practice Address - Country:US
Practice Address - Phone:404-500-7913
Practice Address - Fax:912-550-4883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-26
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty