Provider Demographics
NPI:1770801037
Name:TRANSITION CHIROPRACTIC INC
Entity type:Organization
Organization Name:TRANSITION CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:A
Authorized Official - Last Name:REGIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC PT
Authorized Official - Phone:678-665-0455
Mailing Address - Street 1:1745 WOODSTOCK RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-2367
Mailing Address - Country:US
Mailing Address - Phone:678-665-0455
Mailing Address - Fax:770-643-0060
Practice Address - Street 1:1745 WOODSTOCK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-2367
Practice Address - Country:US
Practice Address - Phone:678-665-0455
Practice Address - Fax:770-643-0060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-12
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
GA008364111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty