Provider Demographics
NPI:1275374001
Name:PEACHTREE CORNERS CHIROPRACTIC PLUS LLC
Entity type:Organization
Organization Name:PEACHTREE CORNERS CHIROPRACTIC PLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:JERRY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-409-1960
Mailing Address - Street 1:3949 HOLCOMB BRIDGE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-2208
Mailing Address - Country:US
Mailing Address - Phone:770-368-0333
Mailing Address - Fax:
Practice Address - Street 1:3949 HOLCOMB BRIDGE RD STE 201
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-2208
Practice Address - Country:US
Practice Address - Phone:770-368-0333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service