Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 5896 | GA |
NPI | 1245432202 |
---|---|
Provider Name | Angelo Frank Ferrari |
First Address | Kennesaw, GA 30144 |
Second Address | Kennesaw, GA 30144-6421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2007 |
Last Update Date | 08/07/2007 |