Provider Demographics
NPI:1932584083
Name:100 PERCENT CHIROPRACTIC ATLANTA SEVEN LLC
Entity Type:Organization
Organization Name:100 PERCENT CHIROPRACTIC ATLANTA SEVEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICO
Authorized Official - Middle Name:
Authorized Official - Last Name:STAPLES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:678-324-1016
Mailing Address - Street 1:125 BARRETT PKWY
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-3331
Mailing Address - Country:US
Mailing Address - Phone:678-324-1016
Mailing Address - Fax:678-401-7647
Practice Address - Street 1:125 BARRETT PKWY
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-3331
Practice Address - Country:US
Practice Address - Phone:678-324-1016
Practice Address - Fax:678-401-7647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-29
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009463111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty