Provider Demographics
NPI:1336469881
Name:BORN, THOMAS JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JAMES
Last Name:BORN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:THOMAS
Other - Middle Name:JAMES
Other - Last Name:BORN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:1512 PIEDMONT AVE NE
Mailing Address - Street 2:SUITE #201
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-5044
Mailing Address - Country:US
Mailing Address - Phone:404-408-0143
Mailing Address - Fax:
Practice Address - Street 1:1512 PIEDMONT AVE NE
Practice Address - Street 2:SUITE #201
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-5044
Practice Address - Country:US
Practice Address - Phone:404-408-0143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-07
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR004737111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor