Provider Demographics
NPI:1235360603
Name:AUSTIN, MARSHA ESTHER (DC)
Entity Type:Individual
Prefix:DR
First Name:MARSHA
Middle Name:ESTHER
Last Name:AUSTIN
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 1:4801 BAKER GROVE RD NW
Mailing Address - Street 2:APT. 406
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-6323
Mailing Address - Country:US
Mailing Address - Phone:678-251-8094
Mailing Address - Fax:
Practice Address - Street 1:4500 S MAIN ST
Practice Address - Street 2:SUITE 104
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-5475
Practice Address - Country:US
Practice Address - Phone:678-251-8094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO0815111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor