Organization
ALIVE TOUCH HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERESA GRACE FOURRE D.C. (OWNER)
(770) 345-7885
Entity
Organization
Contact information
Practice address
4080 HOLLY SPRINGS PKWY, CANTON, GA 30115-7410
(770) 345-7885
(770) 345-7883
Mailing address
4080 HOLLY SPRINGS PKWY, CANTON, GA 30115-7410
(770) 345-7885
(770) 345-7883
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
CHIR006079
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1972642296
INDIVIDUAL NPI
GA
01
—
35ZCFVJ
MEDICARE PART B
GA
01
—
52726673
BLUE CROSS / BLUE SHIELD
—
Enumeration date
06/04/2009
Last updated
06/04/2009
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