Provider Demographics
NPI:1801411459
Name:100 PERCENT CHIROPRACTIC BARCLAY LLC
Entity Type:Organization
Organization Name:100 PERCENT CHIROPRACTIC BARCLAY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ASIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BARCLAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:678-596-7632
Mailing Address - Street 1:6855 FOXFIRE PL
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30349-1384
Mailing Address - Country:US
Mailing Address - Phone:678-596-7632
Mailing Address - Fax:
Practice Address - Street 1:6855 FOXFIRE PL
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30349-1384
Practice Address - Country:US
Practice Address - Phone:678-596-7632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty