Individual
VIDA KHALILI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
1400 HEMBREE RD STE 130, ROSWELL, GA 30076-5711
(404) 671-8499
(404) 671-8490
Mailing address
3717 CHEROKEE PLACE, MARRIETTA, GA 30067
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIRO009055
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CHIRO09065
LICENSE
GA
Enumeration date
06/14/2013
Last updated
02/09/2023
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