Provider Demographics
NPI:1952504334
Name:UPPER SPECIFIC
Entity Type:Organization
Organization Name:UPPER SPECIFIC
Other - Org Name:UPPER CERVICAL SPECIFIC CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:S
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:II
Authorized Official - Credentials:DC
Authorized Official - Phone:404-589-8571
Mailing Address - Street 1:344 LUCKIE ST NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30313-1724
Mailing Address - Country:US
Mailing Address - Phone:404-589-8571
Mailing Address - Fax:
Practice Address - Street 1:344 LUCKIE ST NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30313-1724
Practice Address - Country:US
Practice Address - Phone:404-589-8571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007512111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty