Provider Demographics
NPI:1124295076
Name:THE CENTERED BODY FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:THE CENTERED BODY FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:STRANGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:814-937-5507
Mailing Address - Street 1:1705 MOUNT VERNON RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-4261
Mailing Address - Country:US
Mailing Address - Phone:770-936-9707
Mailing Address - Fax:770-936-9717
Practice Address - Street 1:1705 MOUNT VERNON RD
Practice Address - Street 2:SUITE B
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-4261
Practice Address - Country:US
Practice Address - Phone:770-936-9707
Practice Address - Fax:770-936-9717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8221111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty