Provider Demographics
NPI:1689891483
Name:HUMBER-KIRK CHIROPRACTIC CLINIC, LLC
Entity Type:Organization
Organization Name:HUMBER-KIRK CHIROPRACTIC CLINIC, LLC
Other - Org Name:ATLAS CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUMBER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-251-4345
Mailing Address - Street 1:190 HANDLEY RD STE B
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:GA
Mailing Address - Zip Code:30290-2178
Mailing Address - Country:US
Mailing Address - Phone:404-768-8008
Mailing Address - Fax:404-768-9303
Practice Address - Street 1:820 EBENEZER CHURCH RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SHARPSBURG
Practice Address - State:GA
Practice Address - Zip Code:30277-2073
Practice Address - Country:US
Practice Address - Phone:770-251-4345
Practice Address - Fax:770-251-8072
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUMBER-KIRK-UMBERGER-HOWELL CHIROPRACTIC CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-20
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCGPPMedicare PIN
GA35ZCGPRMedicare PIN
GA35ZCHXKMedicare PIN
GA35ZCGVQMedicare PIN
GAGRP4264Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
GA35ZCGPQMedicare PIN