Organization
INNER SANCTUARY CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIMA MAHALLATI D.C. (OWNER)
(404) 993-1140
Entity
Organization
Contact information
Practice address
165 DEKALB INDUSTRIAL WAY, SUITE B5, DECATUR, GA 30030-2230
(404) 993-1140
Mailing address
165 DEKALB INDUSTRIAL WAY, SUITE B5, DECATUR, GA 30030-2230
(404) 993-1140
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR008617
GA
Other
Enumeration date
09/05/2012
Last updated
09/05/2012
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