Dirty Boots LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIR009627 Issued in GA

Legal business name

DIRTY BOOTS LLC

Practice address

252 Hicks Dr SE
Marietta, GA 30060-3408

Phone

(515) 422-0171

NPI assigned

Jan 20, 2016

Organization subpart

No

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

Authorized official

Name

Marissa Hols, DC

Title

Owner

Phone

(515) 422-0171

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1453248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453248000000",
    "number": "1780041830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 HICKS DR SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300603408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 HICKS DR SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300603408",
            "telephone_number": "515-422-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRTY BOOTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-20",
        "last_updated": "2016-01-20",
        "status": "A",
        "authorized_official_last_name": "HOLS",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-422-0171",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR009627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janie Dinh, FNP
• Jessica Quynh Dinh
• Etalemahu Dinku, M.D.
• Joel Louis Dinoff, D.C.
• Diana Dinser, D.C.
• Dale Wesley Disbro Jr., DC
• Melanie Diane Disco
• Andrew G Dishman, LPC
• Olivia Dison
• Joseph Distefano, DPM

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2016; 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.