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Individual

FRANK R DEBARTOLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
266 SHOE FACTORY RD, SUITE 3, BLAIRSVILLE, GA 30512-4628
(706) 745-1677
(706) 745-1677
Mailing address
PO BOX 1729, BLAIRSVILLE, GA 30514-1729

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2432
GA
111N00000X
Chiropractor
2775
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00640758A
GA
Enumeration date
09/17/2006
Last updated
02/05/2010
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