Provider Demographics
NPI:1730244641
Name:PRAY, CHARLES GEORGE (DC)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:GEORGE
Last Name:PRAY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2551 BATTLEFIELD PKWY
Mailing Address - Street 2:
Mailing Address - City:FORT OGLETHORPE
Mailing Address - State:GA
Mailing Address - Zip Code:30742-4035
Mailing Address - Country:US
Mailing Address - Phone:706-866-8273
Mailing Address - Fax:706-858-7673
Practice Address - Street 1:2551 BATTLEFIELD PKWY
Practice Address - Street 2:
Practice Address - City:FORT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-4035
Practice Address - Country:US
Practice Address - Phone:706-866-8273
Practice Address - Fax:706-858-7673
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR005459111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCDFDMedicare ID - Type Unspecified
GAU51981Medicare UPIN