NPI 1003051343

The Back Shack LLC

Organisation Chiropractor Stone Mountain, GA

Practice location

Address: 6740 James B Rivers Dr, Stone Mountain, GA 30083-2235
Phone: (404) 775-9642

Authorised official

Name: David Feschuk
Title: Doctor
Phone: (404) 775-9642

Registered specialties

Chiropractor Primary

Chiropractic Providers Taxonomy 111N00000X Licence CHIR006338 (GA)

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Registry record

NPI: 1003051343
Entity type: Organization
NPI issued: 15 Dec 2008
Record last updated: 23 Apr 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.