Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | CHIR007089 | GA |
NPI | 1265575161 |
---|---|
Provider Name | Dr. Matthew Germain |
First Address | Atlanta, GA 30307-2248 |
Second Address | Atlanta, GA 30307-2248 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 08/07/2007 |