Provider Demographics
NPI:1427199702
Name:HIEBER, JEANETTE MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:JEANETTE
Middle Name:MARIE
Last Name:HIEBER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JEANETTE
Other - Middle Name:MARIE
Other - Last Name:ARUNDALE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1170 HUNTER TRL
Mailing Address - Street 2:
Mailing Address - City:BOGART
Mailing Address - State:GA
Mailing Address - Zip Code:30622-1570
Mailing Address - Country:US
Mailing Address - Phone:678-753-0465
Mailing Address - Fax:
Practice Address - Street 1:1580 MARS HILL RD STE B
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-4836
Practice Address - Country:US
Practice Address - Phone:706-769-9009
Practice Address - Fax:706-769-9327
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIIR007191111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP4932Medicare ID - Type Unspecified