Provider Demographics
NPI:1922280395
Name:WEST FAMILY CHIROPRACTIC
Entity Type:Organization
Organization Name:WEST FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-255-6027
Mailing Address - Street 1:6100 LAKE FORREST DRIVE STE 320
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3835
Mailing Address - Country:US
Mailing Address - Phone:404-255-6027
Mailing Address - Fax:404-255-4858
Practice Address - Street 1:6100 LAKE FORREST DRIVE STE 320
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3835
Practice Address - Country:US
Practice Address - Phone:404-255-6027
Practice Address - Fax:404-255-4858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2785111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU72216Medicare UPIN