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Organization

DYNAMIC SPINE CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DUSTIN R WALTON D.C. (CO OWNER/ CLINICAL DIRECTOR)
(770) 742-9801
Entity
Organization

Contact information

Practice address
2836 HIGHWAY 54, SUITE 2836, PEACHTREE CITY, GA 30269-1026
(770) 742-9801
Mailing address
2836 HIGHWAY 54, SUITE 2836, PEACHTREE CITY, GA 30269-1026
(770) 742-9801

Taxonomy

Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
CHIR009256
GA
111NS0005X
Sports Physician Chiropractor
CHIR009256
GA

Other

Enumeration date
08/14/2014
Last updated
08/14/2014
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