Provider Demographics
NPI:1477767804
Name:KOURAJIAN, DARIN CHRIS (DC)
Entity Type:Individual
Prefix:
First Name:DARIN
Middle Name:CHRIS
Last Name:KOURAJIAN
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 1:321 RANDALL CT
Mailing Address - Street 2:
Mailing Address - City:LOCUST GROVE
Mailing Address - State:GA
Mailing Address - Zip Code:30248-7028
Mailing Address - Country:US
Mailing Address - Phone:678-457-0153
Mailing Address - Fax:
Practice Address - Street 1:3079 CAMPBELLTON SWRD 205
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30311-5400
Practice Address - Country:US
Practice Address - Phone:678-457-0153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007458111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCHXVMedicare ID - Type UnspecifiedPROVIDER NUMBER