Provider Demographics
NPI:1528180627
Name:CRANTON, PETER R (DC)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:R
Last Name:CRANTON
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 1:2300 PEACHTREE RD NE
Mailing Address - Street 2:B204
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1142
Mailing Address - Country:US
Mailing Address - Phone:404-355-3455
Mailing Address - Fax:404-355-3665
Practice Address - Street 1:2300 PEACHTREE RD NE
Practice Address - Street 2:B204
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1142
Practice Address - Country:US
Practice Address - Phone:404-355-3455
Practice Address - Fax:404-355-3665
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIROO6268111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACHIROO6268OtherSTATE LICENSE
GA01-0696764OtherTAX ID #
GA35ZCGWWMedicare ID - Type Unspecified
GACHIROO6268OtherSTATE LICENSE