Organization
SOUTHEAST CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI ZUBECK D.C. (MANAGER)
(912) 585-7124
Entity
Organization
Contact information
Practice address
775 KINGS BAY RD STE A, SAINT MARYS, GA 31558-3886
(912) 576-1234
(912) 510-5000
Mailing address
775-A KINGS BAY RD, SAINT MARYS, GA 31558
(912) 576-1234
(912) 510-5000
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR008512
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356670749
NPI OF PROVIDER
GA
Enumeration date
11/15/2012
Last updated
11/15/2012
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