Provider Demographics
NPI:1386410611
Name:YANKEE CHIRO CORPORATION
Entity type:Organization
Organization Name:YANKEE CHIRO CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LESSARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-455-7408
Mailing Address - Street 1:2734 HARBOR CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30115-9579
Mailing Address - Country:US
Mailing Address - Phone:919-455-7408
Mailing Address - Fax:
Practice Address - Street 1:3775 SIXES RD # H-120
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-7832
Practice Address - Country:US
Practice Address - Phone:919-455-7408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-28
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service