Provider Demographics
NPI:1851575500
Name:ATHENS CHIROPRACTIC & THERAPY
Entity Type:Organization
Organization Name:ATHENS CHIROPRACTIC & THERAPY
Other - Org Name:NO
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/PRESODENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:W
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:912-657-7635
Mailing Address - Street 1:PO BOX 806
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-0018
Mailing Address - Country:US
Mailing Address - Phone:912-657-7635
Mailing Address - Fax:912-354-8302
Practice Address - Street 1:196 ALPS RD
Practice Address - Street 2:SUITE 26
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-4085
Practice Address - Country:US
Practice Address - Phone:912-657-7635
Practice Address - Fax:912-355-1848
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATHENS CHIROPRACTIC & THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-18
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO06508302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization