Provider Demographics
NPI:1548391634
Name:IOVINO, CARA ANNE (BS,DC)
Entity Type:Individual
Prefix:DR
First Name:CARA
Middle Name:ANNE
Last Name:IOVINO
Suffix:
Gender:F
Credentials:BS,DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 GARDEN WILDE PL
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-7196
Mailing Address - Country:US
Mailing Address - Phone:404-550-7433
Mailing Address - Fax:404-781-4410
Practice Address - Street 1:275 CARPENTER DR NE
Practice Address - Street 2:SUITE 209
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4928
Practice Address - Country:US
Practice Address - Phone:404-255-4401
Practice Address - Fax:404-781-4410
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006834111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCHDWMedicare UPIN
GAGRP4903Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER