Pine Mountain Chiropractic Center, LLC

Organization Active NPI Health Service Clinic/Center · Pine Mountain, GA

NPI 1023201217 · NPPES record last updated Aug 22, 2007

Key facts

NPI
1023201217
Entity type
Organization (NPI type 2)
Primary specialty
Health Service Clinic/Center 261QH0100X
License
2301000RN (GA)
Legal business name
PINE MOUNTAIN CHIROPRACTIC CENTER, LLC
Practice address
624 N Main Ave
Pine Mountain, GA 31822-2403
Phone
(706) 663-8801
NPI assigned
Aug 22, 2007
Organization subpart
No

Authorized official

Name
Kim W. Russell, MANAGING MEMBER
Title
Office Manager
Phone
(706) 663-8801

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

624 N Main Ave
Pine Mountain, GA 31822
Phone (706) 663-8001

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 2301000RN GA Yes

Addresses

Primary practice location

624 N Main Ave
Pine Mountain, GA 31822-2403

Mailing address

624 N Main Ave
P.O. Box 1690
Pine Mountain, GA 31822-2403
Phone (706) 663-8801

Other providers in Pine Mountain, GA

All providers in Pine Mountain, GA · Health Service Clinic/Center in Georgia

Sources for this page

Verify at the official NPI Registry.