Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 2325 | GA |
NPI | 1427243161 |
---|---|
Provider Name | Dr. David Pellington |
First Address | Covington, GA 30014-1478 |
Second Address | Covington, GA 30014-1478 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2007 |
Last Update Date | 06/09/2007 |