Provider Demographics
NPI:1801593512
Name:LAMOLLI, CHAVELLY (DC)
Entity type:Individual
Prefix:
First Name:CHAVELLY
Middle Name:
Last Name:LAMOLLI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7646 SCHOMBURG RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-1816
Mailing Address - Country:US
Mailing Address - Phone:706-507-4000
Mailing Address - Fax:
Practice Address - Street 1:4490 CHAMBLEE DUNWOODY RD STE D
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-6259
Practice Address - Country:US
Practice Address - Phone:770-457-1571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010950111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor