Provider Demographics
NPI:1821525783
Name:GROVETOWN CHIROPRACTIC INCORPORATED
Entity Type:Organization
Organization Name:GROVETOWN CHIROPRACTIC INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONAID
Authorized Official - Middle Name:
Authorized Official - Last Name:SEALS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:706-400-4333
Mailing Address - Street 1:5170 WRIGHTSBORO RD STE A
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813-2885
Mailing Address - Country:US
Mailing Address - Phone:706-400-4333
Mailing Address - Fax:
Practice Address - Street 1:5170 WRIGHTSBORO RD STE A
Practice Address - Street 2:
Practice Address - City:GROVETOWN
Practice Address - State:GA
Practice Address - Zip Code:30813-2885
Practice Address - Country:US
Practice Address - Phone:706-400-4333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009776111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty