Provider Demographics
NPI:1255998464
Name:100 PERCENT CHIROPRACTIC MAASSEN LLC
Entity type:Organization
Organization Name:100 PERCENT CHIROPRACTIC MAASSEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:REED
Authorized Official - Last Name:MAASSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:712-470-2122
Mailing Address - Street 1:2292 TWIGGS CV NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-4208
Mailing Address - Country:US
Mailing Address - Phone:712-470-2122
Mailing Address - Fax:
Practice Address - Street 1:2990 EAGLE DR STE 102
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-5575
Practice Address - Country:US
Practice Address - Phone:712-470-2122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty