Organization
DYNAMIC SPINE AND SPORTS THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERED MICHAEL HULL CHIROPRACTIC (MEMBER)
(678) 674-5430
Entity
Organization
Contact information
Practice address
3400 BLUE SPRINGS RD NW, SUITE 100, KENNESAW, GA 30144-1079
(678) 674-5430
Mailing address
3400 BLUE SPRINGS RD NW, SUITE 100, KENNESAW, GA 30144-1079
(678) 674-5430
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
055355792
GA
Other
Enumeration date
08/21/2012
Last updated
08/21/2012
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