NPIMap

Organization Active NPI

Eagle Chiropractic Clinic Inc

  • Independent Medical Examiner Chiropractor
  • Stockbridge, GA
National Provider Identifier
1427224724
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Medical Examiner ChiropractorTaxonomy code 111NI0013X
License
CH7373 Issued in GA
Legal business name
EAGLE CHIROPRACTIC CLINIC INC
Practice address
616 Eagles Landing Pkwy
Suite-10
Stockbridge, GA 30281-5096
Phone
(678) 565-1500
Fax
(678) 565-7411
NPI assigned
May 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michael Andrew Bruno, D.C.
Title
President
Phone
(678) 565-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Medical Examiner ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NI0013X CH7373 GA Primary

Addresses

Primary practice location

616 Eagles Landing Pkwy
Suite-10
Stockbridge, GA 30281-5096

Mailing address

616 Eagles Landing Pkwy
Suite-10
Stockbridge, GA 30281-5096
Phone (678) 565-1500

National Provider Directory

National Provider Directory

Locations

616 Eagles Landing Pkwy
Ste 10
Stockbridge, GA 30281
Phone (678) 565-1500

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442966400000",
    "number": "1427224724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 EAGLES LANDING PKWY",
            "address_2": "SUITE-10",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815096",
            "telephone_number": "678-565-1500",
            "fax_number": "678-565-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 EAGLES LANDING PKWY",
            "address_2": "SUITE-10",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302815096",
            "telephone_number": "678-565-1500",
            "fax_number": "678-565-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE CHIROPRACTIC CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-06",
        "last_updated": "2015-09-23",
        "status": "A",
        "authorized_official_last_name": "BRUNO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-565-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NI0013X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Independent Medical Examiner",
            "state": "GA",
            "license": "CH7373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.