National Provider Identifier Database

EASTSIDE ALLIED HEALTH LLC
Chiropractor

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.


Contact Information

EASTSIDE ALLIED HEALTH, LLC
3081 STONE MOUNTAIN ST
LITHONIA, GA30058-4426
Phone: 770-482-1114
Fax: 770-484-1206
Website:
Specialty Taxonomy Code
* Chiropractor 111N00000X
General Practice 208D00000X
Internal Medicine 207R00000X

* Indicates primary specialty

NPI Profile & details for EASTSIDE ALLIED HEALTH, LLC

NPI Number 1568582179
Legal business name
LBN
EASTSIDE ALLIED HEALTH, LLC
Authorized official KHAMIS IBRAHIM - (CLINIC DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 03/29/2007
Last updated 09/11/2025 - About 9 months ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: 018820
  • GA License #: 021747
  • GA License #: CHIR006698

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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