Provider Demographics
NPI:1619231891
Name:SEFIC, TIJANA (DC)
Entity Type:Individual
Prefix:DR
First Name:TIJANA
Middle Name:
Last Name:SEFIC
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 1:2850 DELK RD SE APT 4G
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-5355
Mailing Address - Country:US
Mailing Address - Phone:706-254-4579
Mailing Address - Fax:
Practice Address - Street 1:2993 SANDY PLAINS RD STE 115
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-4695
Practice Address - Country:US
Practice Address - Phone:706-254-4579
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-02
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008933111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor