Organization
TODD SUPNICK DC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD MICHAEL SUPNICK DC (OWNER)
(770) 262-1909
Entity
Organization
Contact information
Practice address
2829 DALLAS ST, STE B, KENNESAW, GA 30144-2722
(770) 262-1909
Mailing address
2829 DALLAS ST, STE B, KENNESAW, GA 30144-2722
(770) 262-1909
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR007097
GA
Other
Enumeration date
08/25/2009
Last updated
08/25/2009
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