Provider Demographics
NPI:1689997553
Name:RAGLAND CHIROPRACTIC CENTER, LLC
Entity Type:Organization
Organization Name:RAGLAND CHIROPRACTIC CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:RAGLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-867-2115
Mailing Address - Street 1:PO BOX 267
Mailing Address - Street 2:
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-0267
Mailing Address - Country:US
Mailing Address - Phone:770-867-2115
Mailing Address - Fax:770-867-5115
Practice Address - Street 1:82 W CANDLER ST
Practice Address - Street 2:
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-2502
Practice Address - Country:US
Practice Address - Phone:770-867-2115
Practice Address - Fax:770-867-5115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR001872111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty