Organization
STRUCTURAL BASED THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL ANGELO MAIORINO DC (PRESIDENT)
(678) 469-4133
Entity
Organization
Contact information
Practice address
3719 OLD ALABAMA RD, SUITE 400 A, ALPHARETTA, GA 30022-8675
(678) 469-4133
Mailing address
3719 OLD ALABAMA RD, SUITE 400 A, ALPHARETTA, GA 30022-8675
(678) 469-4133
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR008110
GA
111N00000X
Chiropractor
X009403-1
NY
174400000X
Specialist
MT004280
GA
Other
Enumeration date
08/19/2011
Last updated
08/19/2011
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