Art of Life Chiropractic LLC
Organization Active NPI Chiropractor · Tyrone, GA
NPI 1124639620 · NPPES record last updated Sep 23, 2020
Key facts
- NPI
- 1124639620
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- ART OF LIFE CHIROPRACTIC LLC
- Practice address
- 105 Greencastle Rd Ste B
Tyrone, GA 30290-2945 - Phone
- (770) 632-1995
- Fax
- (770) 486-0224
- NPI assigned
- Aug 10, 2020
- Organization subpart
- No
Authorized official
- Name
- Eric Shearer
- Title
- Owner
- Phone
- (770) 632-1995
Practitioners 1
-
Eric A Shearer, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201030001113 | GA | Part B Supplier - Clinic/Group Practice | 2769892850 |
Receives reassigned benefits from 1 practitioner Practice locations: Tyrone, GA |
National Provider Directory
Locations
105 Greencastle Rd
Ste B
Tyrone, GA 30290
Phone (770) 486-1011
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
105 Greencastle Rd Ste B
Tyrone, GA 30290-2945
Mailing address
105 Greencastle Rd Ste B
Tyrone, GA 30290-2945
Phone (770) 632-1995
Other providers in Tyrone, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.