Provider Demographics
NPI:1376897447
Name:HOLLEN, AUSTIN GERALD (DC)
Entity Type:Individual
Prefix:DR
First Name:AUSTIN
Middle Name:GERALD
Last Name:HOLLEN
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 1:5025 WINTERS CHAPEL RD STE H
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30360-1700
Mailing Address - Country:US
Mailing Address - Phone:770-399-1800
Mailing Address - Fax:770-399-5380
Practice Address - Street 1:11030 MEDLOCK BRIDGE RD STE 230
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-3504
Practice Address - Country:US
Practice Address - Phone:678-694-1113
Practice Address - Fax:678-694-1676
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-29
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009038111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor