Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | CHIR008811 | GA |
NPI | 1215208244 |
---|---|
Provider Name | Dr. Amber Stokes |
First Address | Austell, GA 30106-1118 |
Second Address | Austell, GA 30106-1118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2012 |
Last Update Date | 23/01/2012 |