Healthcare Provider Details

I. General information

NPI: 1740597947
Provider Name (Legal Business Name): JOSEPH P LOMBARDI D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2010
Last Update Date: 09/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

924 FOX LN SE
MARIETTA GA
30067-5722
US

IV. Provider business mailing address

924 FOX LN SE
MARIETTA GA
30067-5722
US

V. Phone/Fax

Practice location:
  • Phone: 770-955-9258
  • Fax:
Mailing address:
  • Phone: 770-955-9258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License NumberCHIR002740
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: