Provider Demographics
NPI:1407926710
Name:MATHIAK, KAREN I (DC)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:I
Last Name:MATHIAK
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 1:202 NORTH EXPRESSWAY
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30223-2015
Mailing Address - Country:US
Mailing Address - Phone:770-229-5433
Mailing Address - Fax:678-692-8904
Practice Address - Street 1:202 NORTH EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30223-2015
Practice Address - Country:US
Practice Address - Phone:770-229-5433
Practice Address - Fax:678-692-8904
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO02394111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor