Provider Demographics
NPI:1821277096
Name:FAMILY CHIROPRACTORS, PC
Entity Type:Organization
Organization Name:FAMILY CHIROPRACTORS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VINCE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:706-342-7115
Mailing Address - Street 1:1163 EATONTON RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:GA
Mailing Address - Zip Code:30650-2026
Mailing Address - Country:US
Mailing Address - Phone:706-342-7115
Mailing Address - Fax:706-342-7670
Practice Address - Street 1:1163 EATONTON RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:GA
Practice Address - Zip Code:30650-2026
Practice Address - Country:US
Practice Address - Phone:706-342-7115
Practice Address - Fax:706-342-7670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5507111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP2862Medicare PIN