| Maltese Chiropractic Life Center, P.c. | |
|
900 Indian Trail Lilburn Rd Nw Ste 9 Lilburn GA 30047-6869 | |
| (770) 381-0491 | |
| Not Available |
| Full Name | Maltese Chiropractic Life Center, P.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 900 Indian Trail Lilburn Rd Nw Ste 9, Lilburn, Georgia |
| Authorized Official Name and Position | John P. Maltese (CEO) |
| Authorized Official Contact | 7703810491 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maltese Chiropractic Life Center, P.c. 900 Indian Trail Lilburn Rd Nw Ste 9 Lilburn GA 30047-6869 Ph: (770) 381-0491 | Maltese Chiropractic Life Center, P.c. 900 Indian Trail Lilburn Rd Nw Ste 9 Lilburn GA 30047-6869 Ph: (770) 381-0491 |
| NPI Number | 1770840472 |
|---|---|
| Provider Enumeration Date | 04/18/2012 |
| Last Update Date | 04/18/2012 |
| Medicare PECOS PAC ID | 5799948485 |
|---|---|
| Medicare Enrollment ID | O20120516000288 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770840472 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | CHIR02313 (Georgia) | Primary |
| Provider Name | John P Maltese |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1215061155 PECOS PAC ID: 9032372727 Enrollment ID: I20120516000379 |
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