Provider Demographics
NPI:1790805356
Name:CHIROCARE CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:CHIROCARE CHIROPRACTIC, INC.
Other - Org Name:CHIROCAREGENE BERBENICK DC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:BERBENICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:229-227-0026
Mailing Address - Street 1:327 E JACKSON ST STE B
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-5175
Mailing Address - Country:US
Mailing Address - Phone:229-227-0026
Mailing Address - Fax:
Practice Address - Street 1:327 E JACKSON ST STE B
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-5175
Practice Address - Country:US
Practice Address - Phone:229-227-0026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2793111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty