Provider Demographics
NPI:1407066590
Name:TURNER, KRYSTAL D (DC)
Entity Type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:D
Last Name:TURNER
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:PO BOX 90639
Mailing Address - Street 2:
Mailing Address - City:EAST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30364-0639
Mailing Address - Country:US
Mailing Address - Phone:404-761-4441
Mailing Address - Fax:404-761-4553
Practice Address - Street 1:2781 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-6941
Practice Address - Country:US
Practice Address - Phone:404-761-4441
Practice Address - Fax:404-761-4553
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006349111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU72769Medicare UPIN
GA357CHFNMedicare ID - Type Unspecified