WILLACOOCHEE CHIROPRACTIC CLINIC (NPI# 1649443417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649443417 |
| Entity Type | Organization |
| Organization Name | WILLACOOCHEE CHIROPRACTIC CLINIC |
| Practice Address |
1161 Highway 135 S Suite 1 Willacoochee GA 31650-7747 |
| Mailing Address |
Po Box 1100 Willacoochee GA 31650-1100 |
| Practice Telephone | 9123810064 |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2008-04-11 |
| Authorized Official Name | DR. PENNY T. JACKSON (CHIROPRACTOR) |
| Authorized Official Telephone | 9123810064 |
| Authorized Official Credential | D,C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CHIR008305 | GA | Chiropractic Providers |
| Street Address |
1161 HIGHWAY 135 S SUITE 1 |
| City | WILLACOOCHEE |
| State | GA |
| Zip Code | 31650-7747 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194997270 | Penny Tronell Jackson | Chiropractor | 1161 Highway 135 S, Suite 1, Willacoochee, GA 31650-7747 | 2008-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083108807 | Sherry R Brogdon | Contractor | 176 Heritage Hill Road, Willacoochee, GA 31650 | 2018-06-15 |
| 1114114055 | Douglas Medical Specialist | Internal Medicine | 134 E Fleetwood Ave, Willacoochee, GA 31650 | 2007-09-25 |
| 1568591287 | Andrew Lee Jackson | Dentist | 600 Mccranie Avenue, Willacoochie, GA 31650 | 2007-03-06 |
| 1851446454 | Sls Pharmacy Inc | Pharmacy | 561 East Main Street, Willacoochee, GA 31650 | 2007-01-24 |
| 1891815924 | John David Rowe Jr. | Physician Assistant | 134 Fleetwood Ave E, Willacoochee, GA 31650-2730 | 2007-03-30 |
| 1649670894 | Irwin County Hospital | Internal Medicine | 134 Fleetwood Ave E, Willacoochee, GA 31650-2730 | 2014-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083108807 | Sherry R Brogdon | Contractor | 176 Heritage Hill Road, Willacoochee, GA 31650 | 2018-06-15 |
| 1114114055 | Douglas Medical Specialist | Internal Medicine | 134 E Fleetwood Ave, Willacoochee, GA 31650 | 2007-09-25 |
| 1891815924 | John David Rowe Jr. | Physician Assistant | 134 Fleetwood Ave E, Willacoochee, GA 31650-2730 | 2007-03-30 |
| 1851446454 | Sls Pharmacy Inc | Pharmacy | 561 East Main Street, Willacoochee, GA 31650 | 2007-01-24 |
| 1649670894 | Irwin County Hospital | Internal Medicine | 134 Fleetwood Ave E, Willacoochee, GA 31650-2730 | 2014-08-25 |
| 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 |
|---|---|---|---|---|
| 1194997270 | Penny Tronell Jackson | Chiropractor | 1161 Highway 135 S, Suite 1, Willacoochee, GA 31650-7747 | 2008-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386245249 | Aaron D Young | Chiropractor | 860 Baltimore Pl Sw, Marietta, GA 30064-3959 | 2020-11-05 |
| 1831790435 | Li Ma | Chiropractor | 376 Powder Springs St Ste 141, Marietta, GA 30064-3460 | 2020-11-02 |
| 1124627260 | Jordan Louis Mallamace | Chiropractor | 6110 Mcfarland Station Dr Unit 400, Alpharetta, GA 30004-6806 | 2020-10-20 |
| 1043818693 | 100 Percent Chiropractic Gibson LLC | Chiropractor | 11 Charley Harper Dr Ste 140, Cartersville, GA 30120-0027 | 2020-10-15 |
| 1376140616 | Springfield Chiropractic LLC | Chiropractor | 505 N Laurel St, Springfield, GA 31329-6815 | 2020-10-08 |
| 1871190363 | Rebel Medical Group LLC | Chiropractor | 2920 Marietta Hwy Ste 102, Canton, GA 30114-8207 | 2020-10-07 |
| 1285231902 | Austin Fortner | Chiropractor | 485 Pooler Pkwy, Pooler, GA 31322-5102 | 2020-10-06 |
| 1073129441 | Ian Michael Koll | Chiropractor | 6100 Lake Forrest Dr Ste 320, Atlanta, GA 30328-3835 | 2020-09-21 |
| 1558977397 | Kristin Best | Chiropractor | 1189 Ashborough Dr Se Apt A, Marietta, GA 30067-6918 | 2020-09-17 |
| 1952915357 | Shaun Olsen | Chiropractor | 600 Houze Way Ste E1, Roswell, GA 30076-1434 | 2020-09-02 |
| Find all providers with the same taxonomy | ||||
| City | WILLACOOCHEE |
| Zip Code | 31650 |
Please comment or provide details below to improve the information on WILLACOOCHEE CHIROPRACTIC CLINIC.
| 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.