Provider Demographics
NPI:1922171545
Name:DELFAVERO, NIKLAUS ANDREAS (DC)
Entity Type:Individual
Prefix:DR
First Name:NIKLAUS
Middle Name:ANDREAS
Last Name:DELFAVERO
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 1:2545 LAWRENCEVILLE HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-3241
Mailing Address - Country:US
Mailing Address - Phone:404-377-0011
Mailing Address - Fax:770-939-9353
Practice Address - Street 1:2545 LAWRENCEVILLE HWY STE 100
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-3241
Practice Address - Country:US
Practice Address - Phone:404-377-0011
Practice Address - Fax:770-939-9353
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007655111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor