Provider Demographics
NPI:1780125682
Name:CHOREN, FRANCINE DE OLIVEIRA (LAC)
Entity type:Individual
Prefix:
First Name:FRANCINE
Middle Name:DE OLIVEIRA
Last Name:CHOREN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:FRANCINE
Other - Middle Name:
Other - Last Name:PORTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1292 DUNWOODY LN NE
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:GA
Mailing Address - Zip Code:30319-1514
Mailing Address - Country:US
Mailing Address - Phone:541-914-3509
Mailing Address - Fax:
Practice Address - Street 1:1292 DUNWOODY LN NE
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:GA
Practice Address - Zip Code:30319-1514
Practice Address - Country:US
Practice Address - Phone:541-914-3509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-13
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA397171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist