I agree with Linda. The business had, as mentioned, naturally occurring citations, not many but some. I put no effort whatsoever into acquiring more.
I have also accomplished the same thing for 3 different personal injury attorneys. So does that answer your question about competition, Joshua? Attorneys are in a highly competitive field. These are in smaller towns than Atlanta, however. The other is in the construction field, not as competitive but he is going up against other contractors in an area with a population over 1,000,000.
It should be noted that one of my attorneys is ranking #1 for 6 different cities for multiple keywords and in the top half for many others. It's all done with on-page SEO and naturally occurring citations.
It should also be noted that getting citations is only time intensive. It is not hard and won't necessarily set you above your competitors. If every one of your competitors is doing citation building, you're going to have to do more. And when you start doing on-site SEO, you'll only rank as high as 1) your IQ (or the IQ of your SEO), 2) the quality of your SEO training, 3) your experience, and 4) what your budget allows - depending on what you're up against.
And then there's inbound link building...
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I want to add that nothing upsets me more than to see local businesses (actually it's probably their SEOS) resort to keyword stuffing to rank high, like this:
"I'm a San Jose chiropractor providing chiropractic services for clients in San Jose. If you're in San Jose and need a chiropractor, then call our chiropractor office today for a chiropractic appointment. We are located in San Jose so your drive from your home in San Jose won't take long at all. We are a San Jose chiropractor and proud of it."
Makes me weep. Sadly, I'm still seeing this get by, but their day is coming.
When I teach, I tell my audience, you have 2 targets: #1 - your customer; #2 Google, but always put your customer first. Write first for them. Yes, add your keywords in so Google is not confused, but don't ruin your copy like the sample above. You don't need to do that! I get great results without resorting to that. I'm sure Linda does the same. So when we talk about on-page SEO, this is not what we are recommending! Our goal is to get the phone to ring. That kind of "optimization" isn't going to accomplish that.