Provider Demographics
NPI:1023287125
Name:BORJA, ALONZO MEISENZAHL (DC)
Entity type:Individual
Prefix:DR
First Name:ALONZO
Middle Name:MEISENZAHL
Last Name:BORJA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 BUFORD MILL DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-4388
Mailing Address - Country:US
Mailing Address - Phone:678-541-2300
Mailing Address - Fax:678-541-2301
Practice Address - Street 1:1950 BUFORD MILL DR
Practice Address - Street 2:SUITE E
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-4388
Practice Address - Country:US
Practice Address - Phone:678-541-2300
Practice Address - Fax:678-541-2301
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-22
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006165111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCFTFMedicare PIN