Blue Ridge Chiropractic and Life Center
Organization Active NPI Chiropractor · Blue Ridge, GA
NPI 1306197892 · NPPES record last updated Sep 25, 2012
Key facts
- NPI
- 1306197892
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- CHIRO08129 (GA)
- Legal business name
- BLUE RIDGE CHIROPRACTIC AND LIFE CENTER
- Practice address
- 5 W Fain St
Blue Ridge, GA 30513-4451 - Phone
- (706) 946-1215
- Fax
- (706) 946-1216
- NPI assigned
- Sep 25, 2012
- Organization subpart
- No
Authorized official
- Name
- Brandon S Fuzi, D.C.
- Title
- Owner
- Phone
- (706) 946-1215
Practitioners 2
-
Magalie Dean, 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 |
|---|---|---|---|---|
| O20121022000709 | GA | Part B Supplier - Clinic/Group Practice | 2062662331 |
Receives reassigned benefits from 2 practitioners Practice locations: Blue Ridge, GA |
National Provider Directory
Locations
5 W Fain St
Blue Ridge, GA 30513
Phone (706) 946-1215
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | CHIRO08129 | GA | Yes |
Addresses
Primary practice location
5 W Fain St
Blue Ridge, GA 30513-4451
Mailing address
5 W Fain St
Blue Ridge, GA 30513-4451
Phone (706) 946-1215
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 Sep 25, 2012. 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.