Provider Demographics
NPI:1073504494
Name:ESPOSITO, JOSEPH L (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:L
Last Name:ESPOSITO
Suffix:
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 1:1030 ASHEBROOKE CT NE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-2395
Mailing Address - Country:US
Mailing Address - Phone:770-977-4224
Mailing Address - Fax:770-426-1491
Practice Address - Street 1:950 COBB PKWY S
Practice Address - Street 2:STE190
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-6544
Practice Address - Country:US
Practice Address - Phone:770-427-7387
Practice Address - Fax:770-426-1491
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR002298111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP6654OtherGROUP#
GAT92674Medicare UPIN
GA35ZCHVGMedicare ID - Type Unspecified