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Organization
TERRY D. SOUTHERLAND, D.C.P.C.
Active
Organization
TERRY D. SOUTHERLAND, D.C.P.C.
Active
Other names
Hamilton Mill Chiropractic Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY D. SOUTHERLAND D.C. (OWNER/PRESIDENT)
(678) 482-2014
Entity
Organization
Contact information
Practice address
3613 BRASELTON HWY, SUITE 101, DACULA, GA 30019-4665
(678) 482-2014
(678) 482-2997
Mailing address
3613 BRASELTON HWY, SUITE 101, DACULA, GA 30019-4665
(678) 482-2014
(678) 482-2997
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
002477
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35ZCJKV
MEDICARE
GA
Enumeration date
11/10/2012
Last updated
11/10/2012
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