Provider Demographics
NPI:1295047983
Name:JAMES, CRISSIE LATONJA (DC)
Entity type:Individual
Prefix:
First Name:CRISSIE
Middle Name:LATONJA
Last Name:JAMES
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 1:1185 CONCORD RD SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-4260
Mailing Address - Country:US
Mailing Address - Phone:678-217-4983
Mailing Address - Fax:678-743-7314
Practice Address - Street 1:1185 CONCORD RD SE
Practice Address - Street 2:SUITE A
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-4260
Practice Address - Country:US
Practice Address - Phone:678-217-4983
Practice Address - Fax:678-743-7314
Is Sole Proprietor?:No
Enumeration Date:2010-07-09
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007820111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor