# GEORGIA CLINIC OF CHIROPRACTIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538478508
- **Authorized official:** DR. MARK LESLIE HUNTSMAN D.C. (OWNER)
- **Authorized official phone:** (618) 922-2948

## Contact information

- **Practice address:** 205 OLD BLACKSTONE CAMP RD, MARTINEZ, GA 30907-9459
- **Practice address phone:** (618) 922-2948
- **Mailing address:** 205 OLD BLACKSTONE CAMP RD, MARTINEZ, GA 30907-9459

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | CHIR008712 | GA | Yes |

## Other

- **Enumeration date:** 09/24/2010
- **Last updated:** 09/24/2010