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Organization
KI LLC
Active
Organization
KI LLC
Active
Other names
Lithonia Chiropractic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHAMIS WAJDI IBRAHIM D.C. (CLINIC DIRECTOR)
(770) 482-1114
Entity
Organization
Contact information
Practice address
3081 STONE MOUNTAIN ST, LITHONIA, GA 30058-4426
(770) 482-1114
(770) 484-1206
Mailing address
3081 STONE MOUNTAIN ST, LITHONIA, GA 30058-4426
(770) 482-1114
(770) 484-1206
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR006698
GA
Other
Enumeration date
03/28/2007
Last updated
08/22/2020
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