Provider Demographics
NPI:1487930319
Name:EAST POINT CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:EAST POINT CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FARAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:BASSARI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-765-0595
Mailing Address - Street 1:1668 THOMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:EAST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30344-3322
Mailing Address - Country:US
Mailing Address - Phone:404-765-0595
Mailing Address - Fax:404-765-9784
Practice Address - Street 1:1668 THOMPSON AVE
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-3322
Practice Address - Country:US
Practice Address - Phone:404-765-0595
Practice Address - Fax:404-765-9784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006593111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty