Provider Demographics
NPI:1952470338
Name:KRISEL, HOWARD J (DC)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:J
Last Name:KRISEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2255 CUMBERLAND PKWY
Mailing Address - Street 2:BLDG 900
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-4529
Mailing Address - Country:US
Mailing Address - Phone:404-233-3386
Mailing Address - Fax:404-233-3186
Practice Address - Street 1:2255 CUMBERLAND PKWY
Practice Address - Street 2:BLDG 900
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-4529
Practice Address - Country:US
Practice Address - Phone:404-233-3386
Practice Address - Fax:404-233-3186
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GACHIR007836111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCJGKMedicare ID - Type UnspecifiedCARRIER PROVIDER NUMBER
GAV04170Medicare UPIN