Provider Demographics
NPI:1710921572
Name:CNS DOC LLC
Entity Type:Organization
Organization Name:CNS DOC LLC
Other - Org Name:PERIMETER CHIROPRACTIC & WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:TOTH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-455-3399
Mailing Address - Street 1:3767 CHAMBLEE DUNWOODY RD
Mailing Address - Street 2:
Mailing Address - City:CHAMBLEE
Mailing Address - State:GA
Mailing Address - Zip Code:30341-2062
Mailing Address - Country:US
Mailing Address - Phone:770-455-3399
Mailing Address - Fax:770-458-8054
Practice Address - Street 1:3767 CHAMBLEE DUNWOODY RD
Practice Address - Street 2:
Practice Address - City:CHAMBLEE
Practice Address - State:GA
Practice Address - Zip Code:30341-2062
Practice Address - Country:US
Practice Address - Phone:770-455-3399
Practice Address - Fax:770-458-8054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA7055111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU89744Medicare UPIN
GA35ZCGSXMedicare ID - Type Unspecified