Provider Demographics
NPI:1356485270
Name:DELLINGER, WILBUR ALLEN (DC)
Entity Type:Individual
Prefix:
First Name:WILBUR
Middle Name:ALLEN
Last Name:DELLINGER
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 1:4218 MCEVER RD # B
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30566-2237
Mailing Address - Country:US
Mailing Address - Phone:770-503-1700
Mailing Address - Fax:770-503-1783
Practice Address - Street 1:4218 MCEVER RD # B
Practice Address - Street 2:
Practice Address - City:OAKWOOD
Practice Address - State:GA
Practice Address - Zip Code:30566-2237
Practice Address - Country:US
Practice Address - Phone:770-503-1700
Practice Address - Fax:770-503-1783
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR003093111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCCNLMedicare ID - Type Unspecified