Provider Demographics
NPI:1871634881
Name:DANBER INC
Entity Type:Organization
Organization Name:DANBER INC
Other - Org Name:WEST GEORGIA SPINE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MIELCARSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:678-852-4070
Mailing Address - Street 1:624 NEWNAN ST
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-3429
Mailing Address - Country:US
Mailing Address - Phone:770-834-6669
Mailing Address - Fax:770-834-4814
Practice Address - Street 1:624 NEWNAN ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-3429
Practice Address - Country:US
Practice Address - Phone:770-834-6669
Practice Address - Fax:770-834-4814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-11
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA07218111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty