Provider Demographics
NPI:1538297692
Name:TRUJILLO, MARTA MARIA (DC)
Entity Type:Individual
Prefix:MRS
First Name:MARTA
Middle Name:MARIA
Last Name:TRUJILLO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 PEACHTREE INDUSTRIAL BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-7912
Mailing Address - Country:US
Mailing Address - Phone:770-495-3444
Mailing Address - Fax:770-495-3888
Practice Address - Street 1:2800 PEACHTREE INDUSTRIAL BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-7912
Practice Address - Country:US
Practice Address - Phone:770-495-3444
Practice Address - Fax:770-495-3888
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR005830111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor