Provider Demographics
NPI:1720021462
Name:PEYROUX, DAVID M (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:PEYROUX
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 1:1065 BRIDGE MILL AVE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-7717
Mailing Address - Country:US
Mailing Address - Phone:770-881-2191
Mailing Address - Fax:770-992-3676
Practice Address - Street 1:290 HERITAGE WALK
Practice Address - Street 2:SUITE 102
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-6402
Practice Address - Country:US
Practice Address - Phone:678-273-3456
Practice Address - Fax:404-596-8383
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008003111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor