Provider Demographics
NPI:1942372347
Name:BOONE, ANNETTE (DC)
Entity Type:Individual
Prefix:DR
First Name:ANNETTE
Middle Name:
Last Name:BOONE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5370 STONE MOUNTAIN HWY
Mailing Address - Street 2:SUITE 730
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-3581
Mailing Address - Country:US
Mailing Address - Phone:770-498-7879
Mailing Address - Fax:770-498-7662
Practice Address - Street 1:5370 STONE MOUNTAIN HWY
Practice Address - Street 2:SUITE 730
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-3581
Practice Address - Country:US
Practice Address - Phone:770-498-7879
Practice Address - Fax:770-498-7662
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA007034111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor