Provider Demographics
NPI:1073079687
Name:GUNTER, GUY THERON III (DC)
Entity Type:Individual
Prefix:DR
First Name:GUY
Middle Name:THERON
Last Name:GUNTER
Suffix:III
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:PO BOX 422478
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-9478
Mailing Address - Country:US
Mailing Address - Phone:404-255-3110
Mailing Address - Fax:404-256-6547
Practice Address - Street 1:4969 ROSWELL RD STE 100-105
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-2678
Practice Address - Country:US
Practice Address - Phone:404-255-3110
Practice Address - Fax:404-256-6547
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR002424111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition