Provider Demographics
NPI:1386051084
Name:FOOTHILLS MANAGEMENT LLC
Entity type:Organization
Organization Name:FOOTHILLS MANAGEMENT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:KARAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-894-4950
Mailing Address - Street 1:25 FOOTHILLS PKWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MARBLE HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30148-2261
Mailing Address - Country:US
Mailing Address - Phone:770-894-4950
Mailing Address - Fax:770-894-4951
Practice Address - Street 1:25 FOOTHILLS PKWY
Practice Address - Street 2:SUITE 103
Practice Address - City:MARBLE HILL
Practice Address - State:GA
Practice Address - Zip Code:30148-2261
Practice Address - Country:US
Practice Address - Phone:770-894-4950
Practice Address - Fax:770-894-4951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009329111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty