Organization
ENHANCED WELLNESS CLINICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW RAFAEL EISEN D.C. (CLINICAL DIRECTOR)
(770) 552-7500
Entity
Organization
Contact information
Practice address
622 W CROSSVILLE RD STE 100, ROSWELL, GA 30075-2560
(770) 552-7500
(888) 819-9318
Mailing address
622 W CROSSVILLE RD STE 100, ROSWELL, GA 30075-2560
(770) 552-7500
(888) 819-9318
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR007877
GA
111N00000X
Chiropractor
CHIR009680
GA
111N00000X
Chiropractor
CHIR009709
GA
Other
Enumeration date
10/04/2016
Last updated
10/04/2016
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