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Organization
THC MEDICAL LLC
Active
Organization
THC MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL FRANK PROCACCINI DC (MANAGING MEMBER)
(770) 416-9995
Entity
Organization
Contact information
Practice address
6315 SPALDING DR, STE B, NORCROSS, GA 30092-4649
(770) 416-9995
(770) 416-9995
Mailing address
6315 SPALDING DR, STE B, NORCROSS, GA 30092-4649
(770) 416-9995
(770) 416-9995
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
—
NULL
111NR0400X
Rehabilitation Chiropractor
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
05/19/2011
Last updated
05/19/2011
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