Provider Demographics
NPI:1699848390
Name:ZARACH, ROBERT J (DC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:ZARACH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 BUFORD HWY NE
Mailing Address - Street 2:SUITE K
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-1648
Mailing Address - Country:US
Mailing Address - Phone:404-638-8000
Mailing Address - Fax:404-634-8808
Practice Address - Street 1:4005 BUFORD HWY NE
Practice Address - Street 2:SUITE K
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-1648
Practice Address - Country:US
Practice Address - Phone:404-638-8000
Practice Address - Fax:404-634-8808
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA4863111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP6031Medicare ID - Type Unspecified
GAU45135Medicare UPIN