Provider Demographics
NPI:1740395573
Name:DEGLIUMBERTO, ANNETTE MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:MARIE
Last Name:DEGLIUMBERTO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 MEADOW DR
Mailing Address - Street 2:STE J
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-2694
Mailing Address - Country:US
Mailing Address - Phone:678-455-7646
Mailing Address - Fax:678-455-7647
Practice Address - Street 1:101 MEADOW DR
Practice Address - Street 2:SUITE J
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2694
Practice Address - Country:US
Practice Address - Phone:678-455-7646
Practice Address - Fax:678-455-7647
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008113111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor