Provider Demographics
NPI:1053480392
Name:FORTE, JOHN MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:FORTE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6085 LAKE FORREST DR NW
Mailing Address - Street 2:STE 300A
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3892
Mailing Address - Country:US
Mailing Address - Phone:404-531-0501
Mailing Address - Fax:404-531-9562
Practice Address - Street 1:6085 LAKE FORREST DR NW
Practice Address - Street 2:STE 300A
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3892
Practice Address - Country:US
Practice Address - Phone:404-531-0501
Practice Address - Fax:404-531-9562
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA5962111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCFJXMedicare PIN