Provider Demographics
NPI:1447717616
Name:REFRESH CHIROPRACTIC LLC
Entity type:Organization
Organization Name:REFRESH CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:CAPATA
Authorized Official - Last Name:SARLEA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:954-681-2656
Mailing Address - Street 1:1686 HOLLOW BROOK CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-2870
Mailing Address - Country:US
Mailing Address - Phone:954-681-2656
Mailing Address - Fax:
Practice Address - Street 1:425 BUFORD HWY STE 102
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-2692
Practice Address - Country:US
Practice Address - Phone:954-681-2656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty