Provider Demographics
NPI:1023407400
Name:COLBY, NORMAN CLARENCE JR (DC)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:CLARENCE
Last Name:COLBY
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 REGENCY WAY
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-5487
Mailing Address - Country:US
Mailing Address - Phone:770-693-7618
Mailing Address - Fax:770-592-1215
Practice Address - Street 1:1501 REGENCY WAY
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-5487
Practice Address - Country:US
Practice Address - Phone:770-693-7618
Practice Address - Fax:770-592-1215
Is Sole Proprietor?:No
Enumeration Date:2015-01-22
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6871111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor