Provider Demographics
NPI:1801930888
Name:LITTLE, DEBORAH R (DC)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:R
Last Name:LITTLE
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 1:1911 DAVID DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-6824
Mailing Address - Country:US
Mailing Address - Phone:770-437-1879
Mailing Address - Fax:
Practice Address - Street 1:1680 MULKEY RD STE G
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1118
Practice Address - Country:US
Practice Address - Phone:678-458-6544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008150111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation