Provider Demographics
NPI:1174530620
Name:PERKINS, CHRISTOPHER LOVE (DC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LOVE
Last Name:PERKINS
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 1:2715 LOGANVILLE HWY
Mailing Address - Street 2:STE 1B
Mailing Address - City:LOGANVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30052-6660
Mailing Address - Country:US
Mailing Address - Phone:678-985-4556
Mailing Address - Fax:678-985-3997
Practice Address - Street 1:2715 LOGANVILLE HWY
Practice Address - Street 2:STE 1B
Practice Address - City:LOGANVILLE
Practice Address - State:GA
Practice Address - Zip Code:30052-6660
Practice Address - Country:US
Practice Address - Phone:678-985-4556
Practice Address - Fax:678-985-3997
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA006378111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU80559Medicare UPIN
GA35ZCFZSMedicare ID - Type Unspecified