Provider Demographics
NPI:1073196903
Name:ACKER, SHEENA MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:SHEENA
Middle Name:MARIE
Last Name:ACKER
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 1:301 MEMORIAL DR SE UNIT 409
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-2120
Mailing Address - Country:US
Mailing Address - Phone:601-672-1672
Mailing Address - Fax:
Practice Address - Street 1:1195 MILTON TER SE APT 1202
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30315-2426
Practice Address - Country:US
Practice Address - Phone:404-839-4566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010458111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor