Organization
INNATE UNIVERSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HECTOR ORTIZ DC (SOLE MEMBER)
(404) 861-6940
Entity
Organization
Contact information
Practice address
230 RIVERSTONE PKWY STE B, CANTON, GA 30114-6414
(770) 720-0099
(770) 720-0002
Mailing address
230 RIVERSTONE PKWY STE B, CANTON, GA 30114-6414
(770) 720-0099
(770) 720-0002
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR009788
GA
Other
Enumeration date
10/22/2017
Last updated
08/23/2022
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