Provider Demographics
NPI:1619102761
Name:CLAXTON CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:CLAXTON CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:NORBURG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:912-739-8311
Mailing Address - Street 1:PO BOX 777
Mailing Address - Street 2:
Mailing Address - City:CLAXTON
Mailing Address - State:GA
Mailing Address - Zip Code:30417-0777
Mailing Address - Country:US
Mailing Address - Phone:912-739-8311
Mailing Address - Fax:912-739-8314
Practice Address - Street 1:8 W LIBERTY ST
Practice Address - Street 2:
Practice Address - City:CLAXTON
Practice Address - State:GA
Practice Address - Zip Code:30417-2042
Practice Address - Country:US
Practice Address - Phone:912-739-8311
Practice Address - Fax:912-739-8314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-19
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA06080111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty