Organization
LE REVE SPINAL CARE CLINIC CO.
Active
Other names
Le Reve Spinal Care Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMIR ASHKAN BANISHAHI D.C (PRESIDENT/ CHIROPRACTOR)
(310) 795-5265
Entity
Organization
Contact information
Practice address
1827 POWERS FERRY RD SE, BUILDING 7 , SUITE 150, ATLANTA, GA 30339-5621
(678) 401-3803
Mailing address
1827 POWERS FERRY RD SE, BUILDING 7 , SUITE 150, ATLANTA, GA 30339-5621
(678) 401-3803
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CHIR009638
GA
111NI0013X
Independent Medical Examiner Chiropractor
Primary
33704
CA
111NI0013X
Independent Medical Examiner Chiropractor
CHIR009638
GA
111NI0900X
Internist Chiropractor
33704
CA
111NI0900X
Internist Chiropractor
CHIR009638
GA
111NN0400X
Neurology Chiropractor
CHIR009638
GA
111NP0017X
Pediatric Chiropractor
33704
CA
111NR0200X
Radiology Chiropractor
33704
CA
111NR0200X
Radiology Chiropractor
CHIR009638
GA
111NR0400X
Rehabilitation Chiropractor
33704
CA
111NR0400X
Rehabilitation Chiropractor
CHIR009638
GA
111NS0005X
Sports Physician Chiropractor
33704
CA
111NS0005X
Sports Physician Chiropractor
CHIR009638
GA
111NX0800X
Orthopedic Chiropractor
33704
CA
111NX0800X
Orthopedic Chiropractor
CHIR009638
GA
Other
Enumeration date
01/22/2016
Last updated
09/19/2016
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