Provider Demographics
NPI:1740986454
Name:BI-COUNTY CHIROPRACTIC AND REHAB LLC
Entity type:Organization
Organization Name:BI-COUNTY CHIROPRACTIC AND REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:B
Authorized Official - Last Name:PETTIT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:908-801-7777
Mailing Address - Street 1:3417 CANTON RD STE 301
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-2896
Mailing Address - Country:US
Mailing Address - Phone:770-424-5551
Mailing Address - Fax:770-424-5553
Practice Address - Street 1:3417 CANTON RD STE 301
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-2896
Practice Address - Country:US
Practice Address - Phone:770-424-5551
Practice Address - Fax:770-424-5553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-03
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty