Provider Demographics
NPI:1851535207
Name:CULBRETH CHIROPRACTIC CLINIC PC
Entity Type:Organization
Organization Name:CULBRETH CHIROPRACTIC CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:ARCHIBALD
Authorized Official - Middle Name:A
Authorized Official - Last Name:CULBRETH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:912-354-1522
Mailing Address - Street 1:315 COMMERCIAL DR STE C5
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3633
Mailing Address - Country:US
Mailing Address - Phone:912-354-1522
Mailing Address - Fax:
Practice Address - Street 1:315 COMMERCIAL DR STE C5
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3633
Practice Address - Country:US
Practice Address - Phone:912-354-1522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-29
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR001153111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1811062060OtherNPI