Provider Demographics
NPI:1215330261
Name:SUMMIT HEALTH CLINIC,LLC
Entity type:Organization
Organization Name:SUMMIT HEALTH CLINIC,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MEIRAV
Authorized Official - Middle Name:
Authorized Official - Last Name:ERTLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-951-0080
Mailing Address - Street 1:1033 FRANKLIN RD SE
Mailing Address - Street 2:SUITE C
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8060
Mailing Address - Country:US
Mailing Address - Phone:770-951-0080
Mailing Address - Fax:770-980-1500
Practice Address - Street 1:1033 FRANKLIN RD SE
Practice Address - Street 2:SUITE C
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8060
Practice Address - Country:US
Practice Address - Phone:770-951-0080
Practice Address - Fax:770-980-1500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Single Specialty