Provider Demographics
NPI:1730335597
Name:SENFT CHIROPRACTIC PC
Entity type:Organization
Organization Name:SENFT CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:SENFT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-633-6787
Mailing Address - Street 1:2987 CLAIRMONT RD NE
Mailing Address - Street 2:STE 105
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-4448
Mailing Address - Country:US
Mailing Address - Phone:404-633-6787
Mailing Address - Fax:404-633-0573
Practice Address - Street 1:2987 CLAIRMONT RD NE
Practice Address - Street 2:STE 105
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-4448
Practice Address - Country:US
Practice Address - Phone:404-633-6787
Practice Address - Fax:404-633-0573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-13
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR002422111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAT97825Medicare UPIN