Provider Demographics
NPI:1144395773
Name:AGRIPPINA, IGNAZIO (DC)
Entity Type:Individual
Prefix:DR
First Name:IGNAZIO
Middle Name:
Last Name:AGRIPPINA
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 1:1700 ABBEY CT
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-6016
Mailing Address - Country:US
Mailing Address - Phone:770-664-0099
Mailing Address - Fax:770-664-9894
Practice Address - Street 1:1700 ABBEY CT
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-6016
Practice Address - Country:US
Practice Address - Phone:770-664-0099
Practice Address - Fax:770-664-9894
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006020111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU76487Medicare UPIN