Organization
ELAN CHIROPRACTIC AND FAMILY WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEIDRA NICOLE MOODY DC (OWNER)
(347) 205-0709
Entity
Organization
Contact information
Practice address
2896 CHAMBLEE TUCKER RD STE 4, ATLANTA, GA 30341-4009
(770) 457-0584
Mailing address
1272 HOUNDSLAKE DR, MARIETTA, GA 30008-8715
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR008906
GA
Other
Enumeration date
04/17/2012
Last updated
04/25/2012
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