Provider Demographics
NPI:1891883088
Name:NEARY, ANTHONY J (DC)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:J
Last Name:NEARY
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 1:1263 CROWN TER
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-3065
Mailing Address - Country:US
Mailing Address - Phone:678-992-1920
Mailing Address - Fax:770-864-9628
Practice Address - Street 1:6748 JAMESTOWN DR
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-3030
Practice Address - Country:US
Practice Address - Phone:678-992-1920
Practice Address - Fax:770-864-9628
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005252111NN0400X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I354310OtherMEDICARE PTAN
GA202I354310OtherMEDICARE PTAN
GAV10441Medicare UPIN