Organization
DCLC TWO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CURTIS FEDORCHUK (PROVIDER)
(706) 864-5362
Entity
Organization
Contact information
Practice address
131 MECHANIC ST, DAHLONEGA, GA 30533-1337
(706) 864-5362
(706) 864-5761
Mailing address
PO BOX 599, DAHLONEGA, GA 30533-0010
(706) 864-5362
(706) 864-5761
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
07276
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
389233
BCBS
GA
01
—
DF0709
MEDICARE RAILROAD
GA
01
—
GRP6904
MEDICARE
GA
Enumeration date
09/19/2007
Last updated
03/19/2008
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