Provider Demographics
NPI:1700125028
Name:DAHL, ABIGAIL T (DC)
Entity Type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:T
Last Name:DAHL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3186 GLENDALE DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-3820
Mailing Address - Country:US
Mailing Address - Phone:678-933-7800
Mailing Address - Fax:
Practice Address - Street 1:1355 CHURCH STREET EXT NE
Practice Address - Street 2:SUITE C
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-7962
Practice Address - Country:US
Practice Address - Phone:678-933-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009062111N00000X, 111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor