Provider Demographics
NPI:1669743563
Name:LAS PALMAS CHIROPRACTIC/MEDICAL REHAB. CENTER
Entity type:Organization
Organization Name:LAS PALMAS CHIROPRACTIC/MEDICAL REHAB. CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:
Authorized Official - Last Name:SERRANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-934-3240
Mailing Address - Street 1:4852 JIMMY CARTER BLVD
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-3643
Mailing Address - Country:US
Mailing Address - Phone:770-934-3240
Mailing Address - Fax:770-934-2042
Practice Address - Street 1:4852 JIMMY CARTER BLVD
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-3643
Practice Address - Country:US
Practice Address - Phone:770-934-3240
Practice Address - Fax:770-934-2042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-24
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty