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Organization

PERFORMANCE SPORT AND SPINE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TIMOTHY MICHAEL GREGORY DC (CHRIOPRACTOR/OWNER)
(404) 721-4406
Entity
Organization

Contact information

Practice address
1575 OLD ALABAMA RD STE 105, ROSWELL, GA 30076-2133
(404) 721-4406
(404) 601-5101
Mailing address
1575 OLD ALABAMA RD STE 105, ROSWELL, GA 30076-2133
(404) 721-4406
(404) 601-5101

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR005801
GA

Other

Enumeration date
01/31/2018
Last updated
01/31/2018
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