Provider Demographics
NPI:1700432465
Name:EMANATE WELLNESS CHIROPRACTIC, PC
Entity Type:Organization
Organization Name:EMANATE WELLNESS CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-870-0109
Mailing Address - Street 1:905 JUNIPER ST NE STE 108
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-4129
Mailing Address - Country:US
Mailing Address - Phone:404-870-0109
Mailing Address - Fax:404-870-0108
Practice Address - Street 1:905 JUNIPER ST NE STE 108
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-4129
Practice Address - Country:US
Practice Address - Phone:404-870-0109
Practice Address - Fax:404-870-0108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service