Provider Demographics
NPI:1205229143
Name:DR. HEIDI ARABIA LLC
Entity Type:Organization
Organization Name:DR. HEIDI ARABIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:
Authorized Official - Last Name:ARABIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-915-9715
Mailing Address - Street 1:3021 TOWNESIDE LN
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-2519
Mailing Address - Country:US
Mailing Address - Phone:404-915-9715
Mailing Address - Fax:
Practice Address - Street 1:2453 TOWNE LAKE PKWY
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-5525
Practice Address - Country:US
Practice Address - Phone:770-592-2505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0022869111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty