Individual
NICHOLAS J DASTA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
5124 N HENRY BLVD, STOCKBRIDGE, GA 30281-3232
(770) 474-6680
(770) 474-3633
Mailing address
8222 YALE DR, JONESBORO, GA 30236-4046
(404) 290-5374
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR 007487
GA
Other
Enumeration date
06/14/2005
Last updated
07/08/2007
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