Provider Demographics
NPI:1932318540
Name:SATTERWHITE CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:SATTERWHITE CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:SATTERWHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-623-9376
Mailing Address - Street 1:9590 MEDLOCK BRIDGE RD STE E
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-5990
Mailing Address - Country:US
Mailing Address - Phone:770-623-9376
Mailing Address - Fax:770-623-9426
Practice Address - Street 1:9590 MEDLOCK BRIDGE RD STE E
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-5990
Practice Address - Country:US
Practice Address - Phone:770-623-9376
Practice Address - Fax:770-623-9426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR004775111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU30364Medicare UPIN
GA35ZCBZMMedicare ID - Type Unspecified