Provider Demographics
NPI:1275210742
Name:JIMENEZ, CARINA (DC)
Entity Type:Individual
Prefix:
First Name:CARINA
Middle Name:
Last Name:JIMENEZ
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 1:875 FRANKLIN GTWY SE APT 1121
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-2932
Mailing Address - Country:US
Mailing Address - Phone:787-932-6999
Mailing Address - Fax:
Practice Address - Street 1:4850 SUGARLOAF PKWY STE 902
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-2867
Practice Address - Country:US
Practice Address - Phone:404-800-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010748111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor