Provider Demographics
NPI:1659594505
Name:THE SPRINGS CHIROPRACTIC HEALTH CENTRE
Entity Type:Organization
Organization Name:THE SPRINGS CHIROPRACTIC HEALTH CENTRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CARUSOS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:404-705-9339
Mailing Address - Street 1:227 SANDY SPRINGS PL NE
Mailing Address - Street 2:STE J
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5918
Mailing Address - Country:US
Mailing Address - Phone:404-705-9339
Mailing Address - Fax:404-705-9133
Practice Address - Street 1:227 SANDY SPRINGS PL NE
Practice Address - Street 2:STE J
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5918
Practice Address - Country:US
Practice Address - Phone:404-705-9339
Practice Address - Fax:404-705-9133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5403111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCDFKMedicare ID - Type Unspecified
GAU59921Medicare UPIN