Provider Demographics
NPI:1518080068
Name:CONTE, DEREK (DC)
Entity Type:Individual
Prefix:DR
First Name:DEREK
Middle Name:
Last Name:CONTE
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 1:2451 CUMBERLAND PKWY SE
Mailing Address - Street 2:SUITE 3102
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-6136
Mailing Address - Country:US
Mailing Address - Phone:770-803-5483
Mailing Address - Fax:770-803-5484
Practice Address - Street 1:1154 CONCORD RD SE
Practice Address - Street 2:SUITE 'A'
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-4263
Practice Address - Country:US
Practice Address - Phone:770-803-5483
Practice Address - Fax:770-803-5484
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006760111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor