Individual
DR. CAROLYNN SUE HENDRICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
10360 MEDLOCK BRIDGE RD, SUITE J, DULUTH, GA 30097-5927
(770) 813-9660
(770) 813-9661
Mailing address
5305 PINE CIR, CUMMING, GA 30041-8940
(770) 205-3164
(770) 813-9661
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR002952
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1040907
BCBS - ASHN PROVIDER ID #
GA
01
—
2057186
AETNA HMO PROVIDER ID #
GA
01
—
4413651
AETNA PPO PROVIDER ID #
GA
01
—
664620
UHC - ACN PROVIDER ID #
GA
Enumeration date
12/05/2006
Last updated
07/08/2007
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