Provider Demographics
NPI:1841497682
Name:MONNIN FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:MONNIN FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:H
Authorized Official - Last Name:MONNIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-252-8054
Mailing Address - Street 1:2015 SHARPSBURG MCCULLUM RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-5526
Mailing Address - Country:US
Mailing Address - Phone:770-252-8054
Mailing Address - Fax:770-252-8251
Practice Address - Street 1:2015 SHARPSBURG MCCULLUM RD
Practice Address - Street 2:SUITE 109
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-5526
Practice Address - Country:US
Practice Address - Phone:770-252-8054
Practice Address - Fax:770-252-8251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007641111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
V06492Medicare UPIN
35ZCJJGMedicare ID - Type Unspecified