ICEBERG HOLDINGS LLC (NPI# 1225650435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225650435 |
| Entity Type | Organization |
| Organization Name | ICEBERG HOLDINGS LLC |
| Practice Address |
1670 Mckendree Church Rd Ste 400b Lawrenceville GA 30043-4100 |
| Practice Telephone | 6789850444 |
| Practice Fax Number | 4708239759 |
| Mailing Telephone | 6789850444 |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2020-05-11 |
| Authorized Official Name | KAMLESH PATEL (CHIROPRACTOR) |
| Authorized Official Telephone | 6789850444 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 62 Shawnee Trl Se, Marietta, GA 300677316 | 7709718115 | 4708239752 |
| 552 Ponce De Leon Ave Ne Ste 552, Atlanta, GA 303081806 | 7706097246 | 4705582961 |
| 697 Ruskin Dr Ste C, Forest Park, GA 302971077 | 7706097246 | 4705582961 |
| Street Address |
1670 MCKENDREE CHURCH RD STE 400B |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30043-4100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255686002 | Kajal Patel | Chiropractor | 1670 Mckendree Church Rd Ste 400b, Lawrenceville, GA 30043-4100 | 2012-07-18 |
| 1164048245 | Antonio Hill | Chiropractor | 1670 Mckendree Church Rd Ste 400b, Lawrenceville, GA 30043-4100 | 2020-06-24 |
| 1720639461 | Iceberg Health LLC | Chiropractor | 1670 Mckendree Church Rd Ste 400b, Lawrenceville, GA 30043-4100 | 2019-09-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609483882 | Brittany Javier Dunn | Counselor | 2387 Lawrenceville Huntcrest Way, Lawreneville, GA 30043 | 2020-09-30 |
| 1629614037 | Terrea Gina Bridges | Behavior Technician | 2387 Huntcrest Rd, Lawrenceville, GA 30043 | 2019-11-20 |
| 1215581756 | Elegant Lm Management, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1020 Meadowsong Circle, Lawrenceville, GA 30043 | 2019-08-01 |
| 1093299778 | Shareef Nahas | Clinical Medical Laboratory | 1130 Hurricane Shoals Rd, Suite 1800, Lawrenceville, GA 30043 | 2018-09-19 |
| 1649766874 | Nutritionecw LLC | Dietitian, Registered | 1755 North Brown Rd, Ste.200, Lawrenceville, GA 30043 | 2018-07-11 |
| 1962997965 | David Le Nguyen | Dentist | 2000 Riverside Pkwy Ste 200, Lawrenceville, GA 30043 | 2018-06-22 |
| 1932611688 | Asfc Outreach Therapeutic Counseling Services, LLC | Counselor | 1755 North Brown Road, Suite 200, Lawrenceville, GA 30043 | 2017-11-02 |
| 1518486810 | Shira Brey Williams | Specialist/Technologist | 1030 Collins Hill Rd, Lawrenceville, GA 30043 | 2017-09-18 |
| 1700300795 | Nympha J. Mathurin Meadows | Behavioral Analyst | 650 Oxford Crest Ct, Lawrenceville, GA 30043 | 2017-08-01 |
| 1992245591 | Jagruti Chaudhari | Nurse Practitioner | 855 Buford Drive, Lawrenceville, GA 30043 | 2017-03-01 |
| Find all providers in zip 30043 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689290942 | Shelby Kemp | Chiropractor | 455 Grayson Hwy Ste 107, Lawrenceville, GA 30046-7159 | 2020-06-23 |
| 1306499785 | Bryan Acosta | Chiropractor | 471 Scenic Hwy South, Lawrenceville, GA 30046 | 2019-07-24 |
| 1366002651 | Princeton Brain Spine and Sports Medicine, LLC | Chiropractor | 558 Lawrence Square Blvd S, Lawrenceville, NJ 08648-2674 | 2019-06-18 |
| 1205491313 | Youngoh Kim | Chiropractor | 1770 Rutland Pass Dr, Lawrenceville, GA 30045-3726 | 2019-05-03 |
| 1568934719 | Renee Christine Robus | Chiropractor | 136 Franklin Corner Rd Ste 110, Lawrenceville, NJ 08648-2586 | 2018-12-28 |
| 1174005284 | Rita Patel | Chiropractor | 2709 Still Farms Pl, Lawrenceville, GA 30043-6156 | 2018-09-05 |
| 1548760804 | Lawrence Spine & Wellness Pa | Chiropractor | 558 Lawrence Square Blvd South, Lawrenceville, NJ 08648 | 2018-02-13 |
| 1750801205 | Revive Medical Center, LLC | Chiropractor | 753 Old Norcross Rd Ste A, Lawrenceville, GA 30046-4312 | 2017-06-26 |
| 1043602170 | Tn Chiropractic Clinic, LLC | Chiropractor | 1848 Old Norcross Rd Ste A400, Lawrenceville, GA 30044-2311 | 2015-02-26 |
| 1386045706 | Bruce R. Brilliantine | Chiropractor | 2 Princess Road, Suiet #2, Lawrenceville, NJ 08648 | 2014-09-05 |
| Find all providers in LAWRENCEVILLE | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30043 |
Please comment or provide details below to improve the information on ICEBERG HOLDINGS LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.