Provider Demographics
NPI:1508870106
Name:GARCIA, JOHNNY A (DC)
Entity Type:Individual
Prefix:
First Name:JOHNNY
Middle Name:A
Last Name:GARCIA
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 1:4982 COVINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-2017
Mailing Address - Country:US
Mailing Address - Phone:404-288-8433
Mailing Address - Fax:404-288-8430
Practice Address - Street 1:4982 COVINGTON HWY
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-2017
Practice Address - Country:US
Practice Address - Phone:404-288-8433
Practice Address - Fax:404-288-8430
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007109111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA52890944OtherBCBS OF GA
GA8749052OtherGIGNA
GA52890944OtherBCBS OF GA
GA8749052OtherGIGNA