Provider Demographics
NPI:1700837101
Name:ROSWELL HEALTH & INJURY CENTER, INC.
Entity Type:Organization
Organization Name:ROSWELL HEALTH & INJURY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GRETCHEN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-325-2856
Mailing Address - Street 1:11490 ALPHARETTA HWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-3811
Mailing Address - Country:US
Mailing Address - Phone:770-442-3343
Mailing Address - Fax:770-576-0152
Practice Address - Street 1:11490 ALPHARETTA HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-3811
Practice Address - Country:US
Practice Address - Phone:770-442-3343
Practice Address - Fax:770-576-0152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006697111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty