| Fuller Life Chiropractic Center Pc | |
|
23 East Main St, Manchester, GA 31816 | |
| (678) 432-4755 | |
| Not Available |
| Full Name | Fuller Life Chiropractic Center Pc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 23 East Main St, Manchester, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417129081 | NPI | - | NPPES |
| CK3398 | Other | GA | RIALROAD MEDICARE GROUP# |
| GRP3272 | Other | GA | MEDICARE GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 005224 (Georgia) | Primary |
| Provider Name | Ronald D Fuller |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1477528925 PECOS PAC ID: 0840248027 Enrollment ID: I20060103000547 |
| Provider Name | Christopher W Odom |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1265663389 PECOS PAC ID: 7214076926 Enrollment ID: I20091209000085 |
| Provider Name | George Glennwood Osgoodby |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1831310416 PECOS PAC ID: 1759353428 Enrollment ID: I20110831000273 |
| Provider Name | Carly Cangelosi |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1801443536 PECOS PAC ID: 9133451313 Enrollment ID: I20191022001282 |
| Provider Name | Matthew Supnick |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1588326821 PECOS PAC ID: 9931585775 Enrollment ID: I20221003001831 |
| Provider Name | Vincent Sclafani |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1689362618 PECOS PAC ID: 0244696508 Enrollment ID: I20230511003694 |
| Provider Name | Kimberly Story |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1457520892 PECOS PAC ID: 9335585751 Enrollment ID: I20240307003558 |
| Mailing Address | Practice Location Address |
|---|---|
| Fuller Life Chiropractic Center Pc Po Box 307, Manchester, GA 31816 Ph: (678) 432-4755 | Fuller Life Chiropractic Center Pc 23 East Main St, Manchester, GA 31816 Ph: (678) 432-4755 |
Ashley Crittendon, D.C. Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 23 E Main St, Manchester, GA 31816 Phone: 678-432-4755 Fax: 678-432-4753 | |
Ronald Fuller, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 23 E Main St, Manchester, GA 31816 Phone: 678-432-4755 Fax: 678-432-4753 | |
Fuller Life Chiropractic Center Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 23 East Main Street, Manchester, GA 31816 Phone: 678-432-4755 Fax: 678-432-4753 | |
Fuller Life Solutions Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 23 E Main St, Manchester, GA 31816 Phone: 706-846-4525 |