Provider Demographics
NPI:1528296969
Name:DAWSONVILLE FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:DAWSONVILLE FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:706-265-6300
Mailing Address - Street 1:PO BOX 2097
Mailing Address - Street 2:
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-0037
Mailing Address - Country:US
Mailing Address - Phone:706-265-6300
Mailing Address - Fax:706-265-6301
Practice Address - Street 1:159 HIGHWAY 53 W STE 110
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-3415
Practice Address - Country:US
Practice Address - Phone:706-265-6300
Practice Address - Fax:706-265-6301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-24
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO008376111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty