Organization
KENNESAW MOUNTAIN CLINC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY MICHAEL COMANOR DC ND (PRESIDENT)
(770) 427-0119
Entity
Organization
Contact information
Practice address
850 KENNESAW AVE, C-9, MARIETTA, GA 30060
(770) 427-0119
(770) 485-3018
Mailing address
850 KENNESAW AVE, C-9, MARIETTA, GA 30060
(770) 427-0119
(770) 485-3018
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
004810
GA
Other
Enumeration date
10/22/2010
Last updated
10/22/2010
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