Organization
TERRY D. SOUTHERLAND, D.C.P.C.
Active
Other names
Hamilton Mill Chiropractic Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY D. SOUTHERLAND D.C. (OWNER/PRESIDENT)
(678) 482-2014
Entity
Organization
Contact information
Practice address
3613 BRASELTON HWY, SUITE 101, DACULA, GA 30019-4665
(678) 482-2014
(678) 482-2997
Mailing address
3613 BRASELTON HWY, SUITE 101, DACULA, GA 30019-4665
(678) 482-2014
(678) 482-2997
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
002477
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35ZCJKV
MEDICARE
GA
Enumeration date
11/10/2012
Last updated
11/10/2012
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