Individual
DR. MITCHEL L. THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1815 HIGHWAY 138 SE, SUITE 600, CONYERS, GA 30013-2079
(770) 860-8333
(770) 860-8833
Mailing address
2575 ABBEY RIDGE RD SW, CONYERS, GA 30094-3459
(770) 860-8333
(770) 860-8833
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR002342
GA
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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