Individual
MITCHELL-LEE WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
140 HOWELL RD STE D, TYRONE, GA 30290-2095
(770) 740-5000
Mailing address
10 HORIZON HL, NEWNAN, GA 30265-5659
(404) 797-0092
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR010398
GA
Other
Enumeration date
08/05/2020
Last updated
05/05/2023
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