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Contact Information

FULLER LIFE CHIROPRACTIC CENTER PC
23 EAST MAIN ST
MANCHESTER, GA31816
 Phone: 678-432-4755
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Chiropractor

111N00000X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for FULLER LIFE CHIROPRACTIC CENTER PC

NPI # 1417129081
LBN Legal business name FULLER LIFE CHIROPRACTIC CENTER PC
Authorized official RONALD FULER - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 03/24/2008
Last updated 01/25/2013 - About 13 years ago
Identifiers
GA License # 005224
GA Other GRP3272 MEDICARE GROUP NUMBER
GA Other CK3398 RIALROAD MEDICARE GROUP#
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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