Healthcare Provider Details

I. General information

NPI: 1740359918
Provider Name (Legal Business Name): JOSEPH J. CIPRIANO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 02/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3025 MAPLE DR NE SUITE 2
ATLANTA GA
30305-2618
US

IV. Provider business mailing address

3025 MAPLE DR NE SUITE 2
ATLANTA GA
30305-2618
US

V. Phone/Fax

Practice location:
  • Phone: 404-261-9522
  • Fax:
Mailing address:
  • Phone: 404-261-9522
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number2161
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: