Individual
DR. MASON TAVAKOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
3827 ROSWELL RD, STE 100A, MARIETTA, GA 30062-6297
(770) 402-8510
Mailing address
3827 ROSWELL RD, STE 100A, MARIETTA, GA 30062-6297
(770) 402-8510
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
0104557253
VA
111N00000X
Chiropractor
Primary
CHIR009568
GA
Other
Enumeration date
05/06/2015
Last updated
11/29/2016
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