Provider Demographics
NPI:1902990013
Name:DENKER, BETH ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:ANN
Last Name:DENKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:BETH
Other - Middle Name:ANN
Other - Last Name:DENKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:5885 PINE BROOK RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5252
Mailing Address - Country:US
Mailing Address - Phone:404-274-7702
Mailing Address - Fax:404-256-5595
Practice Address - Street 1:5885 PINE BROOK RD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5252
Practice Address - Country:US
Practice Address - Phone:404-274-7702
Practice Address - Fax:404-256-5595
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR005519111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA582404909OtherTIN