Provider Demographics
NPI:1699033886
Name:GADSDEN SPECIFIC CHIROPRACTIC INC
Entity type:Organization
Organization Name:GADSDEN SPECIFIC CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:T
Authorized Official - Last Name:GADSDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-423-9939
Mailing Address - Street 1:78 ATLANTA ST SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1936
Mailing Address - Country:US
Mailing Address - Phone:770-423-9939
Mailing Address - Fax:770-423-9356
Practice Address - Street 1:78 ATLANTA ST SE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1936
Practice Address - Country:US
Practice Address - Phone:770-423-9939
Practice Address - Fax:770-423-9356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5684111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty