Individual
DR. IVAN CAMILO RODRIGUEZ GOIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1245 VETERAN MEMORIAL HWY SW, SUITE 22, MABLETON, GA 30126
(404) 964-4985
Mailing address
1197 FLAMINGO DR, AUSTELL, GA 30168-6109
(404) 857-9742
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR010018
GA
111NN0400X
Neurology Chiropractor
CHIR010018
GA
111NR0200X
Radiology Chiropractor
CHIR010018
GA
111NR0400X
Rehabilitation Chiropractor
CHIR010018
GA
111NX0800X
Orthopedic Chiropractor
CHIR010018
GA
Other
Enumeration date
04/18/2022
Last updated
04/18/2022
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