Organization
BASIC CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILI GIPSON DC (SELF)
(770) 924-9400
Entity
Organization
Contact information
Practice address
715A BASCOMB COMMERCIAL PKWY, WOODSTOCK, GA 30189-2466
(770) 924-9400
Mailing address
PO BOX 2363, ACWORTH, GA 30102-0007
(770) 924-9400
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR003030
GA
Other
Enumeration date
10/28/2015
Last updated
10/28/2015
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