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Individual

OMAR DAVID NIEVES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1301 SHILOH RD NW STE 811, KENNESAW, GA 30144-7156
(770) 940-2255
Mailing address
228 BROOKHAVEN CT, ACWORTH, GA 30102-2189
(770) 940-2255

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR009929
GA

Other

Enumeration date
11/08/2017
Last updated
11/08/2017
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