Provider Demographics
NPI:1972725943
Name:PARVARDEGARI, SIAVASH (DC)
Entity Type:Individual
Prefix:DR
First Name:SIAVASH
Middle Name:
Last Name:PARVARDEGARI
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 1:1927 VARIATIONS DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329
Mailing Address - Country:US
Mailing Address - Phone:404-486-7770
Mailing Address - Fax:770-452-4289
Practice Address - Street 1:3042 OAKCLIFF RD
Practice Address - Street 2:SUITE 210
Practice Address - City:DORAVILLE
Practice Address - State:GA
Practice Address - Zip Code:30340
Practice Address - Country:US
Practice Address - Phone:770-452-4288
Practice Address - Fax:770-452-4289
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006529111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor