Organization
THACKER CHIROPRACTIC CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITCHEL L. THACKER D.C (CO-OWNER)
(770) 860-8333
Entity
Organization
Contact information
Practice address
1815 HIGHWAY 138 SE, SUITE 600, CONYERS, GA 30013-2079
(770) 860-8333
(770) 860-8833
Mailing address
1815 HIGHWAY 138 SE, SUITE 600, CONYERS, GA 30013-2079
(770) 860-8333
(770) 860-8833
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR002342
GA
Other
Enumeration date
01/08/2007
Last updated
08/06/2010
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