Provider Demographics
NPI:1053523720
Name:ALLMON, PATTY (DC)
Entity type:Individual
Prefix:
First Name:PATTY
Middle Name:
Last Name:ALLMON
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 1:6247 JOE FRANK HARRIS PKWY NW
Mailing Address - Street 2:
Mailing Address - City:ADAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30103-2425
Mailing Address - Country:US
Mailing Address - Phone:770-773-7700
Mailing Address - Fax:
Practice Address - Street 1:6247 JOE FRANK HARRIS PKWY NW
Practice Address - Street 2:
Practice Address - City:ADAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30103-2425
Practice Address - Country:US
Practice Address - Phone:770-773-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO002926111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00497934AMedicaid
GA35ZCBKBMedicare ID - Type Unspecified
GAV17216Medicare UPIN