| |
6102 Banks St Ste C, Lula, GA 30554-5114 | |
(678) 649-8569 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Chiropractor |
Location | 6102 Banks St Ste C, Lula, Georgia |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1477272417 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Primary |
Provider Name | Adrian P Thane |
---|---|
Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1740886175 PECOS PAC ID: 6002284742 Enrollment ID: I20221130001064 |
Mailing Address | Practice Location Address |
---|---|
955 Sims Harris Rd, Lula, GA 30554-4026 Ph: (678) 203-4489 | 6102 Banks St Ste C, Lula, GA 30554-5114 Ph: (678) 649-8569 |
Adrian P Thane, DC Chiropractor Medicare: Medicare Enrolled Practice Location: 6110 Banks St, Lula, GA 30554 Phone: 678-203-4489 |