Provider Demographics
NPI:1013435478
Name:RAINBOW CITY CHIROPRACTIC
Entity Type:Organization
Organization Name:RAINBOW CITY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:678-571-2595
Mailing Address - Street 1:3046 MOSER WAY
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-6340
Mailing Address - Country:US
Mailing Address - Phone:678-571-2595
Mailing Address - Fax:678-668-2492
Practice Address - Street 1:3155 ROSWELL RD NE STE 140
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-1836
Practice Address - Country:US
Practice Address - Phone:678-571-2595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-06
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008202111N00000X, 111NN1001X, 111NP0017X, 111NR0200X, 111NR0400X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
No111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty
No111NP0017XChiropractic ProvidersChiropractorPediatric ChiropractorGroup - Single Specialty
No111NR0200XChiropractic ProvidersChiropractorRadiologyGroup - Single Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty
No111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty