Provider Demographics
NPI:1639594534
Name:SINES, DELBERT GLENN JR (DC, CME)
Entity Type:Individual
Prefix:DR
First Name:DELBERT
Middle Name:GLENN
Last Name:SINES
Suffix:JR
Gender:M
Credentials:DC, CME
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 EVANS MILL DR STE 309
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30157-1623
Mailing Address - Country:US
Mailing Address - Phone:404-313-3198
Mailing Address - Fax:404-420-2461
Practice Address - Street 1:110 EVANS MILL DR STE 309
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30157-1623
Practice Address - Country:US
Practice Address - Phone:404-313-3198
Practice Address - Fax:404-420-2461
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009278111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor