Provider Demographics
NPI:1245308865
Name:PMA HEALTH SERVICES, INC.
Entity type:Organization
Organization Name:PMA HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCWILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-381-6522
Mailing Address - Street 1:4153 LAWRENCEVILLE HWY NW
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-2854
Mailing Address - Country:US
Mailing Address - Phone:770-381-6522
Mailing Address - Fax:770-381-6542
Practice Address - Street 1:4153 LAWRENCEVILLE HWY NW
Practice Address - Street 2:SUITE 3
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-2854
Practice Address - Country:US
Practice Address - Phone:770-381-6522
Practice Address - Fax:770-381-6542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2746111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty