Provider Demographics
NPI:1336492982
Name:ADAMS, GARY R (DC)
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:R
Last Name:ADAMS
Suffix:
Gender:M
Credentials:DC
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Mailing Address - Street 1:2095 HIGHWAY 211 NW
Mailing Address - Street 2:STE 3A
Mailing Address - City:BRASELTON
Mailing Address - State:GA
Mailing Address - Zip Code:30517-3402
Mailing Address - Country:US
Mailing Address - Phone:770-307-0968
Mailing Address - Fax:770-868-0598
Practice Address - Street 1:2095 HIGHWAY 211 NW
Practice Address - Street 2:STE 2-F, PMB #105
Practice Address - City:BRASELTON
Practice Address - State:GA
Practice Address - Zip Code:30517-3402
Practice Address - Country:US
Practice Address - Phone:770-307-0968
Practice Address - Fax:770-868-0598
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
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Provider Licenses
StateLicense IDTaxonomies
GA06757111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor