Provider Demographics
NPI:1619313087
Name:BLISS CHIROPRACTIC INC
Entity Type:Organization
Organization Name:BLISS CHIROPRACTIC INC
Other - Org Name:BRIGHT LIFE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:JOANN
Authorized Official - Last Name:HORNICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:912-777-3717
Mailing Address - Street 1:2 PARK OF COMMERCE BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-7410
Mailing Address - Country:US
Mailing Address - Phone:912-777-3717
Mailing Address - Fax:
Practice Address - Street 1:2 PARK OF COMMERCE BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-7410
Practice Address - Country:US
Practice Address - Phone:912-777-3717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009139111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty