Provider Demographics
NPI:1770554750
Name:JOHN J GIOVANELLI DC PC
Entity type:Organization
Organization Name:JOHN J GIOVANELLI DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:GIOVANELLI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-487-1228
Mailing Address - Street 1:3200 SHAKERAG HL STE A
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-6524
Mailing Address - Country:US
Mailing Address - Phone:770-487-1228
Mailing Address - Fax:770-818-5796
Practice Address - Street 1:3200 SHAKERAG HL STE A
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-6524
Practice Address - Country:US
Practice Address - Phone:770-487-1228
Practice Address - Fax:770-818-5796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-30
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2833111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU41790Medicare UPIN
GA35ZCJSPMedicare PIN