Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 005252 | GA |
N | 111NN0400X | Neurology | 005252 | GA |
NPI | 1891883088 |
---|---|
Provider Name | Anthony J. Neary |
First Address | Marietta, GA 30062-3065 |
Second Address | Alpharetta, GA 30005-3030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 28/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
202I354310 | MEDICARE PTAN (01) | GA |
V10441 | (02) | GA |