Individual
MS. KIMBERLY ANNE VACCARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
5101 OLD HWY 5, SUITE 1, WOODSTOCK, GA 30188
(678) 494-6735
(678) 494-6737
Mailing address
PO BOX 2031, ACWORTH, GA 30102
(678) 494-6735
(678) 494-6737
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4718
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00804207A
—
GA
01
—
4718
CHIROPRACTIC
GA
Enumeration date
05/08/2007
Last updated
07/08/2007
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