Provider Demographics
NPI:1043489974
Name:MAHYAR, ALIREZA A (DC)
Entity Type:Individual
Prefix:DR
First Name:ALIREZA
Middle Name:A
Last Name:MAHYAR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:ALEX
Other - Middle Name:A
Other - Last Name:MAHYAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:2650 HOLCOMB BRIDGE RD
Mailing Address - Street 2:SUITE 750
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022
Mailing Address - Country:US
Mailing Address - Phone:678-381-1184
Mailing Address - Fax:866-553-1572
Practice Address - Street 1:2650 HOLCOMB BRIDGE RD
Practice Address - Street 2:SUITE 750
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022
Practice Address - Country:US
Practice Address - Phone:678-381-1184
Practice Address - Fax:866-553-1572
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008058111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor