Provider Demographics
NPI:1649301995
Name:ELSANGAK, EVA VESELA (DC)
Entity type:Individual
Prefix:DR
First Name:EVA
Middle Name:VESELA
Last Name:ELSANGAK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4840 ROSWELL RD
Mailing Address - Street 2:BLDG D STE 200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-2639
Mailing Address - Country:US
Mailing Address - Phone:404-256-5513
Mailing Address - Fax:404-256-0413
Practice Address - Street 1:4840 ROSWELL RD
Practice Address - Street 2:BLDG D STE 200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-2639
Practice Address - Country:US
Practice Address - Phone:404-256-5513
Practice Address - Fax:404-256-0413
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2943111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor