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EASTSIDE ALLIED HEALTH LLC NPI 1568582179


NPI Information

NPI: 1568582179
Provider Name: EASTSIDE ALLIED HEALTH, LLC
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
3081 STONE MOUNTAIN ST
LITHONIA, GA
ZIP 30058
Phone: (770) 482-1114
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EASTSIDE ALLIED HEALTH, LLC is a chiropractor in Lithonia, GA. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. EASTSIDE ALLIED HEALTH, LLC NPI is 1568582179. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3081 STONE MOUNTAIN ST
LITHONIA, GA
ZIP 30058-426
Phone: (770) 482-1114
Fax: (770) 484-1206

The provider's authorized official is Khamis Wajdi Ibrahim .
The authorized official title is Clinic Director and has the following contact phone number (770) 482-1114.

The enumeration date for this NPI number is 3/29/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractorCHIR006698GEORGIAYes
2207R00000XInternal Medicine021747GEORGIAX
3208D00000XGeneral Practice018820GEORGIAX

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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