Provider Demographics
NPI:1144347840
Name:INCREDIBLE CHIROPRACTIC FAMILY HEALTHCARE CENTER, L.L.C.
Entity type:Organization
Organization Name:INCREDIBLE CHIROPRACTIC FAMILY HEALTHCARE CENTER, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:G
Authorized Official - Last Name:KAGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:678-624-1888
Mailing Address - Street 1:13800 G.A. HWY 9
Mailing Address - Street 2:SUITE H
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004
Mailing Address - Country:US
Mailing Address - Phone:678-624-1888
Mailing Address - Fax:
Practice Address - Street 1:13800 G.A. HWY 9
Practice Address - Street 2:SUITE H
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004
Practice Address - Country:US
Practice Address - Phone:678-624-1888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006821111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA=========OtherTAX ID
GA=========OtherTAX ID
GA35ZCGGWMedicare ID - Type Unspecified