Provider Demographics
NPI:1912233909
Name:DR. CARLY GREENFIELD LLC
Entity Type:Organization
Organization Name:DR. CARLY GREENFIELD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLY
Authorized Official - Middle Name:S
Authorized Official - Last Name:GREENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-877-8979
Mailing Address - Street 1:857 COLLIER RD NW
Mailing Address - Street 2:SUITE 6
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-2532
Mailing Address - Country:US
Mailing Address - Phone:404-877-8979
Mailing Address - Fax:404-351-5933
Practice Address - Street 1:857 COLLIER RD NW
Practice Address - Street 2:SUITE 6
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-2532
Practice Address - Country:US
Practice Address - Phone:404-877-8979
Practice Address - Fax:404-351-5933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-26
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR00851111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty