Provider Demographics
NPI:1972524411
Name:GRICE, JAMIE ANNETTE
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:ANNETTE
Last Name:GRICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1955 BELLS FERRY RD APT 315
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-7023
Mailing Address - Country:US
Mailing Address - Phone:678-355-1019
Mailing Address - Fax:
Practice Address - Street 1:4425 S COBB DR SE
Practice Address - Street 2:SUITE G
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6368
Practice Address - Country:US
Practice Address - Phone:770-444-9191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007928111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor