Provider Demographics
NPI:1154719003
Name:ADVANCED FAMILY WELLNESS GROUP LLC
Entity type:Organization
Organization Name:ADVANCED FAMILY WELLNESS GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAPP
Authorized Official - Suffix:
Authorized Official - Credentials:DC, CCEP
Authorized Official - Phone:770-485-7101
Mailing Address - Street 1:555 SUN VALLEY DR
Mailing Address - Street 2:SUITE A3
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-5612
Mailing Address - Country:US
Mailing Address - Phone:770-485-7101
Mailing Address - Fax:770-485-7101
Practice Address - Street 1:555 SUN VALLEY DR
Practice Address - Street 2:SUITE A3
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5612
Practice Address - Country:US
Practice Address - Phone:770-485-7101
Practice Address - Fax:770-485-7101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008909111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty