Provider Demographics
NPI:1801189907
Name:L&K CHIROPRACTIC SERVICES
Entity Type:Organization
Organization Name:L&K CHIROPRACTIC SERVICES
Other - Org Name:CARE CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LANDIN
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MARZOLF
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:229-248-8499
Mailing Address - Street 1:305 S WEST ST
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:39819-3911
Mailing Address - Country:US
Mailing Address - Phone:229-248-8499
Mailing Address - Fax:229-248-1595
Practice Address - Street 1:305 S WEST ST
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:39819-3911
Practice Address - Country:US
Practice Address - Phone:229-248-8499
Practice Address - Fax:229-248-1595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-23
Last Update Date:2011-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008218111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1730370446OtherPERSONAL NPI
GA1730370446OtherPERSONAL NPI