| The Back Shack Llc | |
|
6740 James B Rivers Dr, Stone Mountain, GA 30083-2235 | |
| (404) 775-9642 | |
| Not Available |
| Full Name | The Back Shack Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 6740 James B Rivers Dr, Stone Mountain, Georgia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003051343 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | CHIR006338 (Georgia) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| The Back Shack Llc 6740 James B Rivers Dr, Stone Mountain, GA 30083-2235 Ph: (404) 775-9642 | The Back Shack Llc 6740 James B Rivers Dr, Stone Mountain, GA 30083-2235 Ph: (404) 775-9642 |
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