Provider Demographics
NPI:1174933956
Name:RAMIREZ, NADIA MAR (DC)
Entity type:Individual
Prefix:DR
First Name:NADIA
Middle Name:MAR
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 N CAMELLIA BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT VALLEY
Mailing Address - State:GA
Mailing Address - Zip Code:31030-3005
Mailing Address - Country:US
Mailing Address - Phone:478-925-2941
Mailing Address - Fax:478-925-0495
Practice Address - Street 1:204 N CAMELLIA BLVD
Practice Address - Street 2:
Practice Address - City:FORT VALLEY
Practice Address - State:GA
Practice Address - Zip Code:31030-3005
Practice Address - Country:US
Practice Address - Phone:478-825-2941
Practice Address - Fax:478-825-0495
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-02
Last Update Date:2017-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009307111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1447601471OtherGROUP NPI
GA202I359405Medicare PIN
GA1447601471OtherGROUP NPI