Provider Demographics
NPI:1366714982
Name:RADIN, DIANE A (DC)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:A
Last Name:RADIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:1750 POWDER SPRINGS RD
Mailing Address - Street 2:STE 230
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064
Mailing Address - Country:US
Mailing Address - Phone:770-429-1400
Mailing Address - Fax:770-426-8828
Practice Address - Street 1:1750 POWDER SPRINGS RD
Practice Address - Street 2:STE 230
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064
Practice Address - Country:US
Practice Address - Phone:770-429-1400
Practice Address - Fax:770-426-8828
Is Sole Proprietor?:No
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GACHIR003065111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU11568Medicare PIN
GA35ZCHGPMedicare PIN