Family Life Chiropractic Center
Organization Active NPI Chiropractor · Blue Ridge, GA
NPI 1265659155 · NPPES record last updated Aug 31, 2007
Key facts
- NPI
- 1265659155
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- FAMILY LIFE CHIROPRACTIC CENTER
- Practice address
- 351 E Highland St
Blue Ridge, GA 30513-4544 - Phone
- (706) 632-2707
- Fax
- (706) 632-2723
- NPI assigned
- Apr 20, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Stacey D Davis, D.C.
- Title
- Owner
- Phone
- (706) 632-2707
Practitioners 10
-
Stacey D Davis, DC
-
Grant Hudson, DC
-
Jason McAfee, D.C.
-
Donna M Bresnan, D.C.
-
Jerimy Jerome Bruce, D.C.
-
Brandon Scott Fuzi, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040503000295 | GA | Part B Supplier - Clinic/Group Practice | 1951399781 |
Receives reassigned benefits from 3 practitioners Practice locations: Blue Ridge, GA |
National Provider Directory
Locations
351 E Highland St
Blue Ridge, GA 30513
Phone (706) 276-1099
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
351 E Highland St
Blue Ridge, GA 30513-4544
Mailing address
PO Box 2671
Blue Ridge, GA 30513-0047
Phone (706) 632-2707
Other providers in Blue Ridge, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2007. 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.