Individual
ADRIAN P THANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
6110 BANKS ST, LULA, GA 30554-2858
(678) 203-4489
Mailing address
6110 BANKS ST, LULA, GA 30554-2858
(678) 649-8569
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIRO010823
GA
111NS0005X
Sports Physician Chiropractor
CHIRO010823
GA
390200000X
Student in an Organized Health Care Education/Training Program
STUDENT-0244982
GA
Other
Enumeration date
12/10/2020
Last updated
05/10/2023
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