Provider Demographics
NPI:1023055423
Name:ADVANCED CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:ADVANCED CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:STEINLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:706-738-7731
Mailing Address - Street 1:1944 WALTON WAY
Mailing Address - Street 2:SUITE H
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30904
Mailing Address - Country:US
Mailing Address - Phone:706-738-7731
Mailing Address - Fax:706-738-4323
Practice Address - Street 1:1944 WALTON WAY
Practice Address - Street 2:SUITE H
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30904
Practice Address - Country:US
Practice Address - Phone:706-738-7731
Practice Address - Fax:706-738-4323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR002663111N00000X
GACHIR001322111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
143583Medicare ID - Type Unspecified