Provider Demographics
NPI:1629233549
Name:EAST POINT CHIROPRACTIC, P.C.
Entity Type:Organization
Organization Name:EAST POINT CHIROPRACTIC, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAEIDEH
Authorized Official - Middle Name:L
Authorized Official - Last Name:SADRI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-765-0595
Mailing Address - Street 1:1668 THOMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:EAST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30344-3322
Mailing Address - Country:US
Mailing Address - Phone:404-765-0595
Mailing Address - Fax:404-765-9784
Practice Address - Street 1:1668 THOMPSON AVE
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-3322
Practice Address - Country:US
Practice Address - Phone:404-765-0595
Practice Address - Fax:404-765-9784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR005729261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00759679AMedicaid
GA00759679AMedicaid