Provider Demographics
NPI:1730401902
Name:GUY, JANA LACIE (DC)
Entity type:Individual
Prefix:DR
First Name:JANA
Middle Name:LACIE
Last Name:GUY
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:PO BOX 5192
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31603-5192
Mailing Address - Country:US
Mailing Address - Phone:229-247-2828
Mailing Address - Fax:229-247-2854
Practice Address - Street 1:701 BAYTREE RD
Practice Address - Street 2:SUITE D
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2880
Practice Address - Country:US
Practice Address - Phone:229-247-2828
Practice Address - Fax:229-247-2854
Is Sole Proprietor?:No
Enumeration Date:2010-02-16
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008575111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor