Provider Demographics
NPI:1750741542
Name:GRANITE CITY FAMILY CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:GRANITE CITY FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:PARHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:706-522-8070
Mailing Address - Street 1:246 HEARD ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ELBERTON
Mailing Address - State:GA
Mailing Address - Zip Code:30635-2437
Mailing Address - Country:US
Mailing Address - Phone:706-522-8070
Mailing Address - Fax:
Practice Address - Street 1:246 HEARD ST
Practice Address - Street 2:SUITE A
Practice Address - City:ELBERTON
Practice Address - State:GA
Practice Address - Zip Code:30635-2437
Practice Address - Country:US
Practice Address - Phone:706-522-8070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-07
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009651111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty