Provider Demographics
NPI:1609057645
Name:OJIIWAWH, ERIIDINA LIIZA (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIIDINA
Middle Name:LIIZA
Last Name:OJIIWAWH
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 1:322 HILLSIDE VILLAGE DR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30317-3147
Mailing Address - Country:US
Mailing Address - Phone:404-438-4955
Mailing Address - Fax:404-549-4600
Practice Address - Street 1:235 E PONCE DE LEON AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-3452
Practice Address - Country:US
Practice Address - Phone:404-826-2819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008005111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor