COFFEE CHIROPRACTIC LLC (NPI# 1275187403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275187403 |
| Entity Type | Organization |
| Organization Name | COFFEE CHIROPRACTIC LLC |
| Practice Address |
1214 Peterson Ave N Ste P Douglas GA 31533-2835 |
| Practice Telephone | 2293923091 |
| Mailing Telephone | 2293923091 |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2019-07-25 |
| Authorized Official Name | WYCLIFF HAROLD STEWART (CHIROPRACTOR/OWNER) |
| Authorized Official Telephone | 9123311432 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | Chiropractic Providers |
| Street Address |
1214 PETERSON AVE N STE P |
| City | DOUGLAS |
| State | GA |
| Zip Code | 31533-2835 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750994034 | Family Home Medical Equipment, LLC | Durable Medical Equipment & Medical Supplies | 1214 Peterson Ave N Ste P, Douglas, GA 31533-2835 | 2020-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508470964 | Swain Drug Company LLC | Pharmacy | 855 Bowens Mill Rd Sw Suite E, Douglas, GA 31533 | 2020-09-03 |
| 1811528649 | Unison Behavioral Health | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 211 North Street, Douglas, GA 31533 | 2020-01-30 |
| 1952940793 | Teresa Smith | Pharmacist | 901 W Ward St, Douglas, GA 31533 | 2019-12-26 |
| 1447641048 | Jennifer Spivey | Nurse Practitioner | 326 Shirley Avenue, Douglas, GA 31533 | 2015-02-18 |
| 1972914497 | Jessica Lynne Courson | Nurse Practitioner | 903 West Ward Street, Suite B, Douglas, GA 31533 | 2014-05-19 |
| 1063840296 | South Central Primary Care Center | Clinic/Center | 303 Shirley Ave, Ste B, Douglas, GA 31533 | 2013-10-25 |
| 1336411008 | Unison Behavioral Health | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 118 Coweta Avenue South, Douglas, GA 31533 | 2012-01-27 |
| 1346482700 | V and V Clinic | Pediatrics | 1020 West Bryan Street, Douglas, GA 31533 | 2009-04-01 |
| 1063650406 | Jayla Snipes Bullock | Speech-Language Pathologist | 618 Bowens Mill Road Sw, Douglas, GA 31533 | 2009-01-22 |
| 1417112707 | Southern Community Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 315 S. Gaskin Ave, Douglas, GA 31533 | 2008-07-25 |
| Find all providers in zip 31533 | ||||
| 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 |
|---|---|---|---|---|
| 1851944607 | Brian Keith Waters | Chiropractor | 403 Ward St W, Douglas, GA 31533-3505 | 2019-07-22 |
| 1417249343 | Joshua Brett Mizell | Chiropractor | 506 Ashley St W, Douglas, GA 31533-2308 | 2011-05-11 |
| 1730485509 | Henry Randall Sheffield | Chiropractor | 410 Ward St E, Douglas, GA 31533-0001 | 2011-01-26 |
| 1477736015 | Ediss Chiropractic, Inc | Chiropractor | 1330 E Richards St, Douglas, WY 82633-2951 | 2007-12-05 |
| 1538360888 | Jay Daniel Zamora | Chiropractor | 1915 E 10th St, Douglas, AZ 85607 | 2007-05-31 |
| 1770612079 | Robert D Keeler | Chiropractor | 1843 Madora Ave, Douglas, WY 82633-3059 | 2007-03-04 |
| 1720139363 | Larry Hutchison | Chiropractor | 1103 Madison Ave N, Douglas, GA 31533-2803 | 2007-01-12 |
| 1669521324 | Stephan Paul Ediss | Chiropractor | 1330 E. Richards, Douglas, WY 82633 | 2007-01-10 |
| 1699843417 | Brent E Miller | Chiropractor | 410 E Ward St, Douglas, GA 31533 | 2006-12-01 |
| 1568402055 | Douglas Chiropractic | Chiropractor | 105 Shirley Ave, Douglas, GA 31533-2325 | 2006-06-07 |
| Find all providers in DOUGLAS | ||||
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| 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.