Provider Demographics
NPI:1427294149
Name:BROWN/WATKINS CHIROPRACTIC CLINIC
Entity type:Organization
Organization Name:BROWN/WATKINS CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:RUDOLPH
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:770-993-3930
Mailing Address - Street 1:500 SUN VALLEY DR STE F2
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-5638
Mailing Address - Country:US
Mailing Address - Phone:770-993-3930
Mailing Address - Fax:404-551-5505
Practice Address - Street 1:500 SUN VALLEY DR STE F2
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5638
Practice Address - Country:US
Practice Address - Phone:770-993-3930
Practice Address - Fax:404-551-5505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-30
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR005282111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty