Provider Demographics
NPI:1578574455
Name:CHOICE CHIROPRACTIC AND WELLNESS, INC.
Entity Type:Organization
Organization Name:CHOICE CHIROPRACTIC AND WELLNESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHA-YI
Authorized Official - Middle Name:
Authorized Official - Last Name:HWANG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:678-205-2313
Mailing Address - Street 1:PO BOX 2548
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-0044
Mailing Address - Country:US
Mailing Address - Phone:678-205-2313
Mailing Address - Fax:
Practice Address - Street 1:500 AMSTERDAM AVE NE STE R
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-3470
Practice Address - Country:US
Practice Address - Phone:678-205-2313
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO07210111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA6410790001Medicare NSC