Provider Demographics
NPI:1629270483
Name:FIRNBACH, TAMERA (DC)
Entity Type:Individual
Prefix:
First Name:TAMERA
Middle Name:
Last Name:FIRNBACH
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 1:5150 STILESBORO RD NW
Mailing Address - Street 2:SUITE 420
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-7744
Mailing Address - Country:US
Mailing Address - Phone:770-425-6068
Mailing Address - Fax:770-425-6085
Practice Address - Street 1:5150 STILESBORO RD NW
Practice Address - Street 2:SUITE 420
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-7744
Practice Address - Country:US
Practice Address - Phone:770-425-6068
Practice Address - Fax:770-425-6085
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006878111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN1001XChiropractic ProvidersChiropractorNutrition