Organization
THE BACK SHACK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID FESCHUK (DOCTOR)
(404) 775-9642
Entity
Organization
Contact information
Practice address
6740 JAMES B RIVERS DR, STONE MOUNTAIN, GA 30083-2235
(404) 775-9642
Mailing address
6740 JAMES B RIVERS DR, STONE MOUNTAIN, GA 30083-2235
(404) 775-9642
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR006338
GA
Other
Enumeration date
12/15/2008
Last updated
04/23/2013
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