Provider Demographics
NPI:1962967034
Name:RISING CHIROPRACTIC LLC
Entity type:Organization
Organization Name:RISING CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:
Authorized Official - Last Name:DRUCKENMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:706-524-8077
Mailing Address - Street 1:625 PONDER PLACE DR STE 2
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-3342
Mailing Address - Country:US
Mailing Address - Phone:706-524-8077
Mailing Address - Fax:
Practice Address - Street 1:625 PONDER PLACE DR STE 2
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3342
Practice Address - Country:US
Practice Address - Phone:706-524-8077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty