Provider Demographics
NPI:1841337789
Name:INTERNATIONAL ALTERNATIVE MEDICINE
Entity type:Organization
Organization Name:INTERNATIONAL ALTERNATIVE MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHAUNSAY
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKWITH
Authorized Official - Suffix:
Authorized Official - Credentials:RA
Authorized Official - Phone:770-934-4266
Mailing Address - Street 1:PO BOX 334
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30085-0334
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4450 HUGH HOWELL RD
Practice Address - Street 2:SUITE 5
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-4727
Practice Address - Country:US
Practice Address - Phone:770-934-4266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty