Provider Demographics
NPI:1578692430
Name:THE CENTER FOR HOLISTIC HEALTH
Entity Type:Organization
Organization Name:THE CENTER FOR HOLISTIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GENE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLERKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:404-929-0604
Mailing Address - Street 1:320 WINN WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-2106
Mailing Address - Country:US
Mailing Address - Phone:404-929-0604
Mailing Address - Fax:404-477-0894
Practice Address - Street 1:320 WINN WAY STE 101
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2106
Practice Address - Country:US
Practice Address - Phone:404-929-0604
Practice Address - Fax:404-477-0894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA05215111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty