Provider Demographics
NPI:1295912962
Name:WHOLISTIC LIVING INC.
Entity type:Organization
Organization Name:WHOLISTIC LIVING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AYESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUHAMMAD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-296-1103
Mailing Address - Street 1:4821 ROCKBRIDGE RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-6148
Mailing Address - Country:US
Mailing Address - Phone:404-296-1103
Mailing Address - Fax:
Practice Address - Street 1:4821 ROCKBRIDGE RD
Practice Address - Street 2:SUITE 10
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-6148
Practice Address - Country:US
Practice Address - Phone:404-296-1103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006896111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty