Provider Demographics
NPI:1942319165
Name:DENNIS W DE GIVE DC PC
Entity Type:Organization
Organization Name:DENNIS W DE GIVE DC PC
Other - Org Name:ASSOCIATED CHIROPRACTIC CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:WESTMORELAND
Authorized Official - Last Name:DE GIVE
Authorized Official - Suffix:SR
Authorized Official - Credentials:DC
Authorized Official - Phone:770-433-0804
Mailing Address - Street 1:2365 SPRING RD SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080
Mailing Address - Country:US
Mailing Address - Phone:770-433-0804
Mailing Address - Fax:770-434-0941
Practice Address - Street 1:2365 SPRING RD SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080
Practice Address - Country:US
Practice Address - Phone:770-433-0804
Practice Address - Fax:770-434-0941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA4901111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1942319165Medicare PIN