Organization
VIDA CHIROPRACTIC CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIELA B PEROSINO D.C. (OFFICE MANAGER/REGISTERED AGENT)
(678) 451-8871
Entity
Organization
Contact information
Practice address
611 HOLCOMB BRIDGE RD STE A, ROSWELL, GA 30076-1769
(678) 451-8871
Mailing address
611-A HOLCOMB BRIDGE RD., ROSWELL, GA 30075-1768
(678) 451-8871
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR007819
GA
Other
Enumeration date
05/20/2010
Last updated
05/20/2010
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