Provider Demographics
NPI:1427258847
Name:WACHMAN CHIROPRACTIC INC.
Entity type:Organization
Organization Name:WACHMAN CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:WACHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-634-2225
Mailing Address - Street 1:1781 CLAIRMONT RD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-4005
Mailing Address - Country:US
Mailing Address - Phone:404-634-2225
Mailing Address - Fax:404-634-9407
Practice Address - Street 1:1781 CLAIRMONT RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-4005
Practice Address - Country:US
Practice Address - Phone:404-634-2225
Practice Address - Fax:404-634-9407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3138111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP7167Medicare UPIN