Provider Demographics
NPI:1487984191
Name:HEALTH CONCEPTS I
Entity type:Organization
Organization Name:HEALTH CONCEPTS I
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:TENA
Authorized Official - Middle Name:L
Authorized Official - Last Name:TROTTER
Authorized Official - Suffix:
Authorized Official - Credentials:D,C
Authorized Official - Phone:678-206-1729
Mailing Address - Street 1:560 N JEFF DAVIS DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-1665
Mailing Address - Country:US
Mailing Address - Phone:770-719-8785
Mailing Address - Fax:770-719-8715
Practice Address - Street 1:560 N JEFF DAVIS DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-1665
Practice Address - Country:US
Practice Address - Phone:770-719-8785
Practice Address - Fax:770-719-8715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-30
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty