Provider Demographics
NPI:1144612144
Name:DESAI, TANVI (DC,)
Entity Type:Individual
Prefix:DR
First Name:TANVI
Middle Name:
Last Name:DESAI
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 1:2150 BRYANT POINTE DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-4699
Mailing Address - Country:US
Mailing Address - Phone:404-509-5524
Mailing Address - Fax:
Practice Address - Street 1:1705 MOUNT VERNON RD STE A
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-4257
Practice Address - Country:US
Practice Address - Phone:404-509-5524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-27
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009447111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor