Provider Demographics
NPI:1780111385
Name:ESAU, ANDREA (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:ESAU
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 1:2761 TERRELL TRACE DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-3233
Mailing Address - Country:US
Mailing Address - Phone:770-630-8057
Mailing Address - Fax:
Practice Address - Street 1:10886 CRABAPPLE RD STE 400-A
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-3026
Practice Address - Country:US
Practice Address - Phone:770-630-8057
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-15
Last Update Date:2017-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009858111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor