Organization
KI LLC
Active
Other names
Lithonia Chiropractic Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHAMIS WAJDI IBRAHIM D.C. (CLINIC DIRECTOR)
(770) 482-1114
Entity
Organization
Contact information
Practice address
3081 STONE MOUNTAIN ST, LITHONIA, GA 30058-4426
(770) 482-1114
(770) 484-1206
Mailing address
3081 STONE MOUNTAIN ST, LITHONIA, GA 30058-4426
(770) 482-1114
(770) 484-1206
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR006698
GA
Other
Enumeration date
03/28/2007
Last updated
08/22/2020
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