Provider Demographics
NPI:1710912928
Name:RUBIN FAMILY CHIROPRACTIC,P.C.
Entity Type:Organization
Organization Name:RUBIN FAMILY CHIROPRACTIC,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:G
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-937-6300
Mailing Address - Street 1:255 VILLAGE PKWY NE
Mailing Address - Street 2:SUITE 620
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-4158
Mailing Address - Country:US
Mailing Address - Phone:770-937-6300
Mailing Address - Fax:770-937-9296
Practice Address - Street 1:255 VILLAGE PKWY NE
Practice Address - Street 2:SUITE 620
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-4158
Practice Address - Country:US
Practice Address - Phone:770-937-6300
Practice Address - Fax:770-937-9296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6579111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCGKTMedicare ID - Type Unspecified
T92302Medicare UPIN