Provider Demographics
NPI:1124843636
Name:CLEAR CARE ACCIDENT AND INJURY
Entity type:Organization
Organization Name:CLEAR CARE ACCIDENT AND INJURY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BIANCA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLDERSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-574-4152
Mailing Address - Street 1:225 FRANKLIN RD UNIT 4407
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-2794
Mailing Address - Country:US
Mailing Address - Phone:570-574-4152
Mailing Address - Fax:
Practice Address - Street 1:225 FRANKLIN RD UNIT 4407
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-2794
Practice Address - Country:US
Practice Address - Phone:570-574-4152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty