Individual
RAVEN MINOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
1050 SHILOH RD NW STE 303, KENNESAW, GA 30144-7197
(770) 370-7588
Mailing address
1050 SHILOH RD NW STE 303, KENNESAW, GA 30144-7197
(770) 370-7588
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR010907
GA
Other
Enumeration date
11/07/2022
Last updated
11/07/2022
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