Provider Demographics
NPI:1275866410
Name:INNER LIGHT ENTERPRISES, INC.
Entity Type:Organization
Organization Name:INNER LIGHT ENTERPRISES, INC.
Other - Org Name:DBA HEALTH MATTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PRESIDENT, DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:BULMASH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-740-8228
Mailing Address - Street 1:11080 OLD ROSWELL ROAD
Mailing Address - Street 2:STE. 100
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-4758
Mailing Address - Country:US
Mailing Address - Phone:770-740-8228
Mailing Address - Fax:770-346-9958
Practice Address - Street 1:11080 OLD ROSWELL ROAD
Practice Address - Street 2:STE. 100
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-4758
Practice Address - Country:US
Practice Address - Phone:770-740-8228
Practice Address - Fax:770-346-9958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-04
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004806111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty