Provider Demographics
NPI:1891868949
Name:SWORD FRASER, GENIA (DC)
Entity Type:Individual
Prefix:MRS
First Name:GENIA
Middle Name:
Last Name:SWORD FRASER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MRS
Other - First Name:GENIA
Other - Middle Name:
Other - Last Name:FRASER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:9434 S MAIN ST
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-8711
Mailing Address - Country:US
Mailing Address - Phone:770-478-1300
Mailing Address - Fax:770-478-9385
Practice Address - Street 1:9434 S MAIN ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-8711
Practice Address - Country:US
Practice Address - Phone:770-478-1300
Practice Address - Fax:770-478-9385
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO06745111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor