Provider Demographics
NPI:1861978504
Name:GALANOS, JORDAN
Entity type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:
Last Name:GALANOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6192 JOE FRANK HARRIS PKWY NW STE D
Mailing Address - Street 2:
Mailing Address - City:ADAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30103-2446
Mailing Address - Country:US
Mailing Address - Phone:770-769-4400
Mailing Address - Fax:
Practice Address - Street 1:6192 JOE FRANK HARRIS PKWY NW STE D
Practice Address - Street 2:
Practice Address - City:ADAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30103-2446
Practice Address - Country:US
Practice Address - Phone:770-769-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-16
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009982111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty