Provider Demographics
NPI:1922135672
Name:GEORGIA CHIROPRACTIC CARE, INC.
Entity Type:Organization
Organization Name:GEORGIA CHIROPRACTIC CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-963-1918
Mailing Address - Street 1:368 W PIKE ST
Mailing Address - Street 2:STE. 202
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-3240
Mailing Address - Country:US
Mailing Address - Phone:770-963-1918
Mailing Address - Fax:770-963-2581
Practice Address - Street 1:368 W PIKE ST
Practice Address - Street 2:STE. 202
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-3240
Practice Address - Country:US
Practice Address - Phone:770-963-1918
Practice Address - Fax:770-963-2581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6793251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management