The Widen Clinic

LBN: The Widen Clinic
The Widen Clinic is an health care organization with primary practice located at 3535 Roswell Rd Ste. 37, Marietta GA 30062-8826. The organization recently has 2 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Podiatric Medicine & Surgery Service Providers / Podiatrist. Podiatric Medicine & Surgery Service Providers / Podiatrist is the primary health care specialty. The Widen Clinic can be contacted via phone (770) 578-1400, or through Widen, Eric Daniel via phone (770) 578-1400.

Contact Information

Primary practice address
3535 Roswell Rd Ste. 37 Marietta GA 30062-8826
Phone: (770) 578-1400
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Widen, Eric Daniel DPM,DC
Phone: (770) 578-1400

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X

Profile Details

NPI number 1073795746
LBN Legal business name The Widen Clinic
DBA Doing business as
Authorized official Widen, Eric Daniel DPM,DC
Entity Organization
Organization subpart 1 No
Enumeration date Dec 4th, 2007
Last updated Dec 4th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073795746 NPPES
Georgia Other GRP6040 MEDICARE GROUP NUMBER

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