Healthcare Provider Details

I. General information

NPI: 1669797148
Provider Name (Legal Business Name): OLENA M PLOTKINA D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 03/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3155 ROSWELL RD NE SUITE 140
ATLANTA GA
30305-1821
US

IV. Provider business mailing address

3155 ROSWELL RD. SUITE 140
ATLANTA GA
30305
US

V. Phone/Fax

Practice location:
  • Phone: 404-384-8498
  • Fax: 404-231-5546
Mailing address:
  • Phone: 404-384-8498
  • Fax: 404-231-5546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR008552
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: