Provider Demographics
NPI:1710004999
Name:DECATUR PAIN & REHAB
Entity Type:Organization
Organization Name:DECATUR PAIN & REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ISAACSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-534-6606
Mailing Address - Street 1:3755 MEMORIAL DR
Mailing Address - Street 2:STE A
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-2253
Mailing Address - Country:US
Mailing Address - Phone:404-534-6606
Mailing Address - Fax:404-534-6602
Practice Address - Street 1:3755 MEMORIAL DR
Practice Address - Street 2:STE A
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032-2253
Practice Address - Country:US
Practice Address - Phone:404-534-6606
Practice Address - Fax:404-534-6602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006296111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty