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Organization
DYNAMIC SPINE AND SPORTS THERAPY
Active
Organization
DYNAMIC SPINE AND SPORTS THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERED MICHAEL HULL CHIROPRACTIC (MEMBER)
(678) 674-5430
Entity
Organization
Contact information
Practice address
3400 BLUE SPRINGS RD NW, SUITE 100, KENNESAW, GA 30144-1079
(678) 674-5430
Mailing address
3400 BLUE SPRINGS RD NW, SUITE 100, KENNESAW, GA 30144-1079
(678) 674-5430
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
055355792
GA
Other
Enumeration date
08/21/2012
Last updated
08/21/2012
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