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Individual

DEBRA A PORTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DC

Contact information

Practice address
2655 DALLAS HWY SW, SUITE 110, MARIETTA, GA 30064-2597
(770) 427-1889
(770) 427-7513
Mailing address
2655 DALLAS HWY SW, SUITE 110, MARIETTA, GA 30064-2597
(770) 427-1889
(770) 427-7513

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
005756
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1001532
AM.SPECIALTY NETWORK
GA
01
52650137
BLUECROSSBLUESHIELD OF GA
GA
01
5707692
AETNA
GA
01
646983
AMERICAN CHIROPRACTIC NET
GA
Enumeration date
02/09/2007
Last updated
07/08/2007
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