Provider Demographics
NPI:1174730493
Name:DRUDA, JOSEPH C (DC)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:C
Last Name:DRUDA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:620 SEA ISLAND RD
Mailing Address - Street 2:# 134
Mailing Address - City:ST SIMONS ISLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31522-1767
Mailing Address - Country:US
Mailing Address - Phone:912-399-8860
Mailing Address - Fax:912-399-8860
Practice Address - Street 1:1700 FREDERICA RD
Practice Address - Street 2:SUITE 202
Practice Address - City:ST SIMONS ISLAND
Practice Address - State:GA
Practice Address - Zip Code:31522-2581
Practice Address - Country:US
Practice Address - Phone:912-268-2783
Practice Address - Fax:912-268-2947
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA007257111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor