Provider Demographics
NPI:1801047576
Name:ATLANTA HEALTH CONNECTION, LLC
Entity type:Organization
Organization Name:ATLANTA HEALTH CONNECTION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:VATISTAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-307-1027
Mailing Address - Street 1:5252 ROSWELL RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1969
Mailing Address - Country:US
Mailing Address - Phone:404-252-7833
Mailing Address - Fax:404-252-7834
Practice Address - Street 1:5252 ROSWELL RD
Practice Address - Street 2:SUITE 102
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1969
Practice Address - Country:US
Practice Address - Phone:404-252-7833
Practice Address - Fax:404-252-7834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-30
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008224111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty