Provider Demographics
NPI:1992357891
Name:CANNING CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:CANNING CHIROPRACTIC LLC
Other - Org Name:CANNING CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORGANIZING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:GEOFFREY
Authorized Official - Last Name:CANNING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:678-488-3222
Mailing Address - Street 1:78 SCENIC HWY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-5729
Mailing Address - Country:US
Mailing Address - Phone:770-513-1591
Mailing Address - Fax:
Practice Address - Street 1:78 SCENIC HWY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-5729
Practice Address - Country:US
Practice Address - Phone:770-513-1591
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-10
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty