Provider Demographics
NPI:1225129802
Name:STONE, PAMELA (DC)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:STONE
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 1:4390 BELLS FERRY RD NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-1354
Mailing Address - Country:US
Mailing Address - Phone:770-926-8746
Mailing Address - Fax:770-926-8742
Practice Address - Street 1:4390 BELLS FERRY RD NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-1354
Practice Address - Country:US
Practice Address - Phone:770-926-8746
Practice Address - Fax:770-926-8742
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006642111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U88406Medicare UPIN
GA35ZCGPZMedicare ID - Type Unspecified