Organization
CHIROPRACTIC CLINIC OF SNELLVILLE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN WILLIAM SIERADZKI D.C. (OWNER)
(770) 982-5155
Entity
Organization
Contact information
Practice address
2331 HENRY CLOWER BLVD STE C, SNELLVILLE, GA 30078-3158
(770) 982-5155
(770) 982-4262
Mailing address
2331 HENRY CLOWER BLVD STE C, SNELLVILLE, GA 30078-3158
(770) 982-5155
(770) 982-4262
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR002081
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35ZCHFF
MEDICARE ID
GA
Enumeration date
11/16/2011
Last updated
11/16/2011
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