Provider Demographics
NPI:1245432202
Name:FERRARI, ANGELO FRANK (DC)
Entity Type:Individual
Prefix:
First Name:ANGELO
Middle Name:FRANK
Last Name:FERRARI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3940 CHEROKEE STREET NORTHWEST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144
Mailing Address - Country:US
Mailing Address - Phone:770-423-9010
Mailing Address - Fax:
Practice Address - Street 1:3940 CHEROKEE ST NW
Practice Address - Street 2:SUITE 402
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-6421
Practice Address - Country:US
Practice Address - Phone:770-423-9010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA5896111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation