Provider Demographics
NPI:1023659885
Name:GIROUARD, MAXIME (DC)
Entity type:Individual
Prefix:DR
First Name:MAXIME
Middle Name:
Last Name:GIROUARD
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 1:505 COMMERCE PARK DR SE STE I
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-2744
Mailing Address - Country:US
Mailing Address - Phone:470-418-1075
Mailing Address - Fax:
Practice Address - Street 1:505 COMMERCE PARK DR SE STE I
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-2744
Practice Address - Country:US
Practice Address - Phone:470-418-1075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010278111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor