Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CHIR005508 | GA |
NPI | 1003921321 |
---|---|
Provider Name | Dr. Dale Adrian Carey |
First Address | Marietta, GA 30067-2709 |
Second Address | Marietta, GA 30062-4762 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U62131 | (02) | AL |