Provider Demographics
NPI:1164744058
Name:TINSLEY, JUSTIN MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:MICHAEL
Last Name:TINSLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:440 ERNEST BARRETT PARKWAY
Mailing Address - Street 2:SUITE 58
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144
Mailing Address - Country:US
Mailing Address - Phone:770-795-0453
Mailing Address - Fax:770-795-0454
Practice Address - Street 1:440 ERNEST BARRETT PARKWAY
Practice Address - Street 2:SUITE 58
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144
Practice Address - Country:US
Practice Address - Phone:770-795-0453
Practice Address - Fax:770-795-0454
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-19
Last Update Date:2015-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008556111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology