Provider Demographics
NPI:1578853677
Name:FLEMONS, EVELYN (DC)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:FLEMONS
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 1:6223 OAKDALE RIDGE CT SE
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-2921
Mailing Address - Country:US
Mailing Address - Phone:770-988-0033
Mailing Address - Fax:770-988-0220
Practice Address - Street 1:2359 WINDY HILL RD SE
Practice Address - Street 2:SUITE 320
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8638
Practice Address - Country:US
Practice Address - Phone:770-988-0033
Practice Address - Fax:770-988-0220
Is Sole Proprietor?:No
Enumeration Date:2011-04-11
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008767111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor