Provider Demographics
NPI:1083249734
Name:HILL, TIA
Entity Type:Individual
Prefix:
First Name:TIA
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 FLAT SHOALS AVE SE STE 4
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-1962
Mailing Address - Country:US
Mailing Address - Phone:404-549-7223
Mailing Address - Fax:404-549-7206
Practice Address - Street 1:457 FLAT SHOALS AVE SE STE 4
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30316-1962
Practice Address - Country:US
Practice Address - Phone:404-549-7223
Practice Address - Fax:404-549-7206
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-03
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HICHIR010327111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty