Provider Demographics
NPI:1730652983
Name:AVARD FAMILY CHIROPRACTIC
Entity type:Organization
Organization Name:AVARD FAMILY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:AVARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:912-826-5230
Mailing Address - Street 1:185 COMMERCIAL DR
Mailing Address - Street 2:
Mailing Address - City:RINCON
Mailing Address - State:GA
Mailing Address - Zip Code:31326-5469
Mailing Address - Country:US
Mailing Address - Phone:912-826-5230
Mailing Address - Fax:
Practice Address - Street 1:185 COMMERCIAL DR
Practice Address - Street 2:
Practice Address - City:RINCON
Practice Address - State:GA
Practice Address - Zip Code:31326-5469
Practice Address - Country:US
Practice Address - Phone:912-826-5230
Practice Address - Fax:912-826-5230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-09
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACHIRO009195OtherCHIROPRACTOR LICENCE NUMBER
SC3504OtherCHIROPRACTOR LICENCE NUMBER