Provider Demographics
NPI:1487400800
Name:GUARIN, ANDREA (DC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:GUARIN
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 1:6015 STATE BRIDGE RD APT 11108
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-8235
Mailing Address - Country:US
Mailing Address - Phone:201-491-1638
Mailing Address - Fax:
Practice Address - Street 1:1255 JOHNSON FERRY RD STE 26
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-2728
Practice Address - Country:US
Practice Address - Phone:678-819-2556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR011177111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor