Organization
MARK W VANDINE
Active
Other names
ACCIDENT AND INJURY CHIROPRACTIC CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELA M PIERCE (BILLING ASSISTANT)
(770) 251-3238
Entity
Organization
Contact information
Practice address
27 BULLSBORO DR, NEWNAN, GA 30263-1570
(770) 251-3238
(770) 251-5340
Mailing address
27 BULLSBORO DR, NEWNAN, GA 30263-1570
(770) 251-3238
(770) 251-5340
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIRO1988
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006501
MEDICARE GROUP NUMBER
GA
Enumeration date
12/12/2007
Last updated
12/12/2007
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