Provider Demographics
NPI:1013166545
Name:ATLANTA SPINAL CORRECTION CENTER LLC
Entity Type:Organization
Organization Name:ATLANTA SPINAL CORRECTION CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC / FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:GRAY
Authorized Official - Last Name:MCWILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-998-1414
Mailing Address - Street 1:11800 NORTHFALL LN STE 1402
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-7976
Mailing Address - Country:US
Mailing Address - Phone:770-998-1414
Mailing Address - Fax:770-998-1470
Practice Address - Street 1:11800 NORTHFALL LN STE 1402
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-7976
Practice Address - Country:US
Practice Address - Phone:770-998-1414
Practice Address - Fax:770-998-1470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005642111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty