Provider Demographics
NPI:1851910103
Name:ATL SPINAL CARE
Entity Type:Organization
Organization Name:ATL SPINAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:470-991-2222
Mailing Address - Street 1:5495 JIMMY CARTER BLVD STE C2
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-1514
Mailing Address - Country:US
Mailing Address - Phone:470-991-8888
Mailing Address - Fax:770-559-4187
Practice Address - Street 1:1630 PLEASANT HILL RD STE 230
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-5828
Practice Address - Country:US
Practice Address - Phone:470-991-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:1ST CHOICE INJURY AND REHAB CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-15
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty