Provider Demographics
NPI:1891353611
Name:WEBB, SAMUEL A (DC)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:A
Last Name:WEBB
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 COBB PKWY S STE 190
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-6500
Mailing Address - Country:US
Mailing Address - Phone:770-427-7387
Mailing Address - Fax:770-426-1491
Practice Address - Street 1:950 COBB PKWY S STE 190
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-6500
Practice Address - Country:US
Practice Address - Phone:770-427-7387
Practice Address - Fax:770-426-1491
Is Sole Proprietor?:No
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010184111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor