| Hencock Chiropractic Llc | |
|
5520 Lilburn Stone Mountain Rd Ste E1 Stone Mountain GA 30087-2876 | |
| (470) 870-8680 | |
| Not Available |
| Full Name | Hencock Chiropractic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5520 Lilburn Stone Mountain Rd Ste E1, Stone Mountain, Georgia |
| Authorized Official Name and Position | Lorenil Hencock Boncek (CHIROPRACTOR) |
| Authorized Official Contact | 4705031551 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hencock Chiropractic Llc 4542 Warrior Trl Sw Lilburn GA 30047-4152 Ph: (470) 503-1551 | Hencock Chiropractic Llc 5520 Lilburn Stone Mountain Rd Ste E1 Stone Mountain GA 30087-2876 Ph: (470) 870-8680 |
| NPI Number | 1578273140 |
|---|---|
| Provider Enumeration Date | 12/05/2022 |
| Last Update Date | 12/05/2022 |
| Medicare PECOS PAC ID | 9931546017 |
|---|---|
| Medicare Enrollment ID | O20240325002938 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578273140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Lorenil Hencock Boncek |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1295343838 PECOS PAC ID: 0840637922 Enrollment ID: I20240326000360 |
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