Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | CHIR009201 | GA |
NPI | 1093123804 |
---|---|
Provider Name | Dr. Pearline Allen |
First Address | Smyrna, GA 30082-3857 |
Second Address | Stockbridge, GA 30281-7274 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2014 |
Last Update Date | 24/07/2014 |