Provider Demographics
NPI:1538677943
Name:DR. DELARAM SHEKARRIZ INC.
Entity Type:Organization
Organization Name:DR. DELARAM SHEKARRIZ INC.
Other - Org Name:LOST MOUNTAIN CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DELARAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEKARRIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-218-0400
Mailing Address - Street 1:1685 MARS HILL RD NW STE 103
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-7180
Mailing Address - Country:US
Mailing Address - Phone:770-218-0400
Mailing Address - Fax:770-218-1160
Practice Address - Street 1:1685 MARS HILL RD NW STE 103
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-7180
Practice Address - Country:US
Practice Address - Phone:770-218-0400
Practice Address - Fax:770-218-1160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-19
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009938111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty