Provider Demographics
NPI:1386871416
Name:HEATHER ROBINSON CAMP LLC/CAMP CHIROPRACTIC
Entity type:Organization
Organization Name:HEATHER ROBINSON CAMP LLC/CAMP CHIROPRACTIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:ROBINSON
Authorized Official - Last Name:CAMP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-920-1707
Mailing Address - Street 1:2080 FAIRBURN RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-1064
Mailing Address - Country:US
Mailing Address - Phone:770-920-1707
Mailing Address - Fax:770-920-0364
Practice Address - Street 1:2080 FAIRBURN RD
Practice Address - Street 2:SUITE F
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-1064
Practice Address - Country:US
Practice Address - Phone:770-920-1707
Practice Address - Fax:770-920-0364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007004111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP5083Medicare PIN