Basic Information
| Provider Information | |||||||||
| NPI: | 1861532129 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SPRAYBERRY CHIROPRACTIC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2475 EAST PIEDMONT RD | ||||||||
| Address2: | |||||||||
| City: | MARIETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30062 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6784324755 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2475 EAST PIEDMONT RD | ||||||||
| Address2: | |||||||||
| City: | MARIETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30062 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6784324755 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | PRICE | ||||||||
| AuthorizedOfficialFirstName: | TIMOTHY | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6784324755 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Chiropractic Providers | Chiropractor |
No ID Information.