Organization
FULL BODY REJUVENETION CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAILAH SMITH D.C. (CHIROPRACTOR/OWNER)
(678) 613-4650
Entity
Organization
Contact information
Practice address
3636 PANOLA RD, SUITE B, LITHONIA, GA 30038-2733
(678) 609-1586
Mailing address
3636 PANOLA RD, SUITE B, LITHONIA, GA 30038-2733
(678) 609-1586
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR007963
GA
Other
Enumeration date
06/16/2008
Last updated
07/15/2008
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