Organization
MEDIPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISHEL CARR (OFFICE MANAGER)
(770) 496-0326
Entity
Organization
Contact information
Practice address
3955 HARRISON ROAD, SUITE 400, LOGANVILLE, GA 30052-8502
(770) 496-0326
Mailing address
3955 HARRISON ROAD, SUITE 400, LOGANVILLE, GA 30052-8502
(770) 496-0326
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
15826
GA
Other
Enumeration date
05/02/2016
Last updated
05/02/2016
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