Provider Demographics
NPI:1831607308
Name:BAYLISS CHIROPRACTIC CENTER LLC
Entity type:Organization
Organization Name:BAYLISS CHIROPRACTIC CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BAYLISS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-580-9294
Mailing Address - Street 1:11800 NORTHFALL LN STE 1402
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-7976
Mailing Address - Country:US
Mailing Address - Phone:770-580-9294
Mailing Address - Fax:
Practice Address - Street 1:11800 NORTHFALL LN STE 1402
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-7976
Practice Address - Country:US
Practice Address - Phone:770-580-9294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-17
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009996111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty