Provider Demographics
NPI:1063629855
Name:HIPOLITO, CAROLYNE ABELLERA (DC)
Entity Type:Individual
Prefix:DR
First Name:CAROLYNE
Middle Name:ABELLERA
Last Name:HIPOLITO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 681911
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-0032
Mailing Address - Country:US
Mailing Address - Phone:678-522-7107
Mailing Address - Fax:770-416-2224
Practice Address - Street 1:5390 PEACHTREE INDUSTRIAL BLVD
Practice Address - Street 2:STE 120
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-4715
Practice Address - Country:US
Practice Address - Phone:770-416-2225
Practice Address - Fax:770-416-2224
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006905111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor