Serra Chiropractic Life Center, P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1495 Issued in GA

Legal business name

SERRA CHIROPRACTIC LIFE CENTER, P.C.

Practice address

1091 West Ave SW
Conyers, GA 30012-5243

Phone

(770) 922-1212

Fax

(770) 922-1213

NPI assigned

Sep 30, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Thomas M. Serra, D.C.

Title

Owner

Phone

(770) 922-1212

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1222732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222732800000",
    "number": "1730339490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1091 WEST AVE SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300125243",
            "telephone_number": "770-922-1212",
            "fax_number": "770-922-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1091 WEST AVE SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300125243",
            "telephone_number": "770-922-1212",
            "fax_number": "770-922-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERRA CHIROPRACTIC LIFE CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-30",
        "last_updated": "2008-09-30",
        "status": "A",
        "authorized_official_last_name": "SERRA",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-922-1212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "1495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Conyers, GA
• Providers in Conyers, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; 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.