Provider Demographics
NPI:1942474978
Name:MIDDLETON CHIROPRACTIC
Entity Type:Organization
Organization Name:MIDDLETON CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:CIROU
Authorized Official - Last Name:MIDDLETON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:706-795-0294
Mailing Address - Street 1:PO BOX 292
Mailing Address - Street 2:
Mailing Address - City:COMER
Mailing Address - State:GA
Mailing Address - Zip Code:30629-0292
Mailing Address - Country:US
Mailing Address - Phone:709-795-0294
Mailing Address - Fax:
Practice Address - Street 1:1960 MAIN ST
Practice Address - Street 2:
Practice Address - City:COMER
Practice Address - State:GA
Practice Address - Zip Code:30629-3712
Practice Address - Country:US
Practice Address - Phone:706-795-0294
Practice Address - Fax:706-795-0295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR001918111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1275552317OtherNPI