Provider Demographics
NPI:1275677544
Name:JUSTICE, JOHN RODNEY (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RODNEY
Last Name:JUSTICE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2353
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-0353
Mailing Address - Country:US
Mailing Address - Phone:770-487-5600
Mailing Address - Fax:770-487-4914
Practice Address - Street 1:1999 HIGHWAY 54 W
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-4747
Practice Address - Country:US
Practice Address - Phone:770-487-5600
Practice Address - Fax:770-487-4911
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1438111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor