Provider Demographics
NPI:1134141070
Name:DOOLY, CYNTHIA SUSAN (DC)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:SUSAN
Last Name:DOOLY
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 1:4228 ADEL HWY
Mailing Address - Street 2:
Mailing Address - City:QUITMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31643-8519
Mailing Address - Country:US
Mailing Address - Phone:229-263-8193
Mailing Address - Fax:
Practice Address - Street 1:317 E SCREVEN ST
Practice Address - Street 2:
Practice Address - City:QUITMAN
Practice Address - State:GA
Practice Address - Zip Code:31643-2131
Practice Address - Country:US
Practice Address - Phone:229-605-9909
Practice Address - Fax:229-605-9900
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006906111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor