Provider Demographics
NPI:1891849204
Name:FLETCHER, DONALD LOWELL (DC)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:LOWELL
Last Name:FLETCHER
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 1:514 W BANKHEAD HWY
Mailing Address - Street 2:# 300
Mailing Address - City:VILLA RICA
Mailing Address - State:GA
Mailing Address - Zip Code:30180-1736
Mailing Address - Country:US
Mailing Address - Phone:770-459-0035
Mailing Address - Fax:770-456-6174
Practice Address - Street 1:514 W BANKHEAD HWY
Practice Address - Street 2:# 300
Practice Address - City:VILLA RICA
Practice Address - State:GA
Practice Address - Zip Code:30180-1736
Practice Address - Country:US
Practice Address - Phone:770-459-0035
Practice Address - Fax:770-456-6174
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA008268111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor