# THC MEDICAL LLC

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

## Provider details

- **NPI number:** 1740573070
- **Authorized official:** MR. MICHAEL FRANK PROCACCINI DC (MANAGING MEMBER)
- **Authorized official phone:** (770) 416-9995

## Contact information

- **Practice address:** 6315 SPALDING DR, STE B, NORCROSS, GA 30092-4649
- **Practice address phone:** (770) 416-9995
- **Practice address fax:** (770) 416-9995
- **Mailing address:** 6315 SPALDING DR, STE B, NORCROSS, GA 30092-4649
- **Mailing address phone:** (770) 416-9995
- **Mailing address fax:** (770) 416-9995

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NR0400X | Rehabilitation Chiropractor | — | NULL | — |
| 111NR0400X | Rehabilitation Chiropractor | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/19/2011
- **Last updated:** 05/19/2011