Provider Demographics
NPI:1770752230
Name:VATISTAS, JOHN GEORGE (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:GEORGE
Last Name:VATISTAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:5252 ROSWELL RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1969
Mailing Address - Country:US
Mailing Address - Phone:404-252-7833
Mailing Address - Fax:404-252-7834
Practice Address - Street 1:5252 ROSWELL RD
Practice Address - Street 2:SUITE 102
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1969
Practice Address - Country:US
Practice Address - Phone:404-252-7833
Practice Address - Fax:404-252-7834
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GACHIR008224111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation