Provider Demographics
NPI:1104571744
Name:ONESPIRIT CHIROPRACTIC AND WELLNESS CENTER, LLC
Entity type:Organization
Organization Name:ONESPIRIT CHIROPRACTIC AND WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIIDINA
Authorized Official - Middle Name:
Authorized Official - Last Name:OJIIWAWH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-438-4955
Mailing Address - Street 1:1821 PENNY LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30043-3537
Mailing Address - Country:US
Mailing Address - Phone:404-438-4955
Mailing Address - Fax:404-393-9293
Practice Address - Street 1:5050 JIMMY CARTER BLVD STE 110
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-2758
Practice Address - Country:US
Practice Address - Phone:404-438-4955
Practice Address - Fax:404-393-9293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NN1001XChiropractic ProvidersChiropractorNutritionGroup - Single Specialty