Provider Demographics
NPI:1881643468
Name:POLK, DONNA M (DC)
Entity type:Individual
Prefix:DR
First Name:DONNA
Middle Name:M
Last Name:POLK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:1544 PIEDMONT AVE NE
Mailing Address - Street 2:SUITE 402
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-5018
Mailing Address - Country:US
Mailing Address - Phone:404-745-9877
Mailing Address - Fax:404-745-9825
Practice Address - Street 1:1544 PIEDMONT AVE NE
Practice Address - Street 2:SUITE 402
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-5018
Practice Address - Country:US
Practice Address - Phone:404-745-9877
Practice Address - Fax:404-745-9825
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2008-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA005934111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAV11726Medicare UPIN
GA35ZCJVNMedicare PIN