Provider Demographics
NPI:1437044484
Name:ONE EIGHTY CHIROPRACTIC LLC
Entity type:Organization
Organization Name:ONE EIGHTY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:NZEKELLANG MBU
Authorized Official - Last Name:ETONGA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-313-6673
Mailing Address - Street 1:3450 ROXBORO RD NE APT 4217
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-1839
Mailing Address - Country:US
Mailing Address - Phone:404-313-6673
Mailing Address - Fax:
Practice Address - Street 1:3295 RIVER EXCHANGE DR STE 308
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-4216
Practice Address - Country:US
Practice Address - Phone:404-490-2460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty