Performance Sport And Spine | |
1575 Old Alabama Rd Ste 105, Roswell, GA 30076-2133 | |
(404) 721-4406 | |
(404) 601-5101 |
Full Name | Performance Sport And Spine |
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Type | Facility |
Speciality | Chiropractor |
Location | 1575 Old Alabama Rd Ste 105, Roswell, Georgia |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1841798279 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | CHIR005801 (Georgia) | Primary |
Provider Name | Timothy Gregory |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1821396854 PECOS PAC ID: 1557511227 Enrollment ID: I20121016000339 |
Mailing Address | Practice Location Address |
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Performance Sport And Spine 1575 Old Alabama Rd Ste 105, Roswell, GA 30076-2133 Ph: (404) 721-4406 | Performance Sport And Spine 1575 Old Alabama Rd Ste 105, Roswell, GA 30076-2133 Ph: (404) 721-4406 |
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