Provider Demographics
NPI:1427358803
Name:MICHAEL C ZOELLER LLC
Entity type:Organization
Organization Name:MICHAEL C ZOELLER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HATRAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-740-9200
Mailing Address - Street 1:6495 SHILOH RD STE A2-110
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-1635
Mailing Address - Country:US
Mailing Address - Phone:770-740-9200
Mailing Address - Fax:770-752-5607
Practice Address - Street 1:6495 SHILOH RD STE A2-110
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-1635
Practice Address - Country:US
Practice Address - Phone:770-740-9200
Practice Address - Fax:770-752-5607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR0007540111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty