Provider Demographics
NPI:1053411587
Name:VIRGILIO, ADAM CRAIG (DC)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:CRAIG
Last Name:VIRGILIO
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 1:982 APALACHEE RUN TRL
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-6704
Mailing Address - Country:US
Mailing Address - Phone:678-376-2251
Mailing Address - Fax:
Practice Address - Street 1:3280 HAMILTON MILL RD
Practice Address - Street 2:SUITE 304
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30519-4003
Practice Address - Country:US
Practice Address - Phone:678-546-8044
Practice Address - Fax:678-546-8047
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006561111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP6096Medicare ID - Type UnspecifiedGROUP NUMBER
GA35ZCHKMMedicare ID - Type Unspecified
GAU96862Medicare UPIN