Individual
DR. MICHAEL CLIFFORD BASILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1624 VIRGINIA AVE, COLLEGE PARK, GA 30337-2824
(404) 781-2225
(404) 781-2226
Mailing address
PO BOX 941188, ATLANTA, GA 31141-0188
(678) 701-2225
(678) 701-2226
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR006552
GA
Other
Enumeration date
03/14/2007
Last updated
07/08/2007
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