Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | 2684 | GA |
NPI | 1194831594 |
---|---|
Provider Name | Dr. Bart Joshua Belcher |
First Address | Marietta, GA 30060-1945 |
Second Address | Marietta, GA 30060-1945 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 08/07/2007 |