Provider Demographics
NPI:1306578604
Name:THOMAS, DAWN MICHELLE (DC)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MICHELLE
Last Name:THOMAS
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 1:3405 DALLAS HWY SW STE 412
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-6427
Mailing Address - Country:US
Mailing Address - Phone:770-281-9396
Mailing Address - Fax:
Practice Address - Street 1:3405 DALLAS HWY SW STE 412
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-6427
Practice Address - Country:US
Practice Address - Phone:770-281-9396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO10045111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor