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Organization
100 CHIRO BOURNE LLC
Active
Organization
100 CHIRO BOURNE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAVEN MICHELLE HOUSE-BOURNE DC (DOCTOR/OWNER)
(504) 333-9084
Entity
Organization
Contact information
Practice address
3512 HIGHWAY 155 N STE A2, MCDONOUGH, GA 30252-5506
(504) 333-9084
Mailing address
403 DARTER DR NW, KENNESAW, GA 30144-5083
(504) 333-9084
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
08/18/2022
Last updated
07/06/2023
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