Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | CHIR007293 | GA |
NPI | 1184780652 |
---|---|
Provider Name | Dr. Joseph Anthony Krzemien |
First Address | Buford, GA 30518-3710 |
Second Address | Buford, GA 30518-3710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2006 |
Last Update Date | 25/02/2013 |