Provider Demographics
NPI:1720571466
Name:DUKE HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:DUKE HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR/ AO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:DUKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-693-0707
Mailing Address - Street 1:PO BOX 3514
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30061-3514
Mailing Address - Country:US
Mailing Address - Phone:770-693-0707
Mailing Address - Fax:770-693-0930
Practice Address - Street 1:1455 BELLS FERRY RD STE 200
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-6078
Practice Address - Country:US
Practice Address - Phone:770-693-0707
Practice Address - Fax:770-693-0930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-07
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA0005676111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty