Healthcare Provider Details

I. General information

NPI: 1639113426
Provider Name (Legal Business Name): CHRISTINE HELENE CHARRAS DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTINE HELENE POULLAIN D.C.

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 02/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 JOHNSON FERRY RD NE
SANDY SPRINGS GA
30328-3820
US

IV. Provider business mailing address

218 JOHNSON FERRY RD NE
SANDY SPRINGS GA
30328-3820
US

V. Phone/Fax

Practice location:
  • Phone: 770-776-0238
  • Fax: 877-329-2799
Mailing address:
  • Phone: 770-776-0238
  • Fax: 877-329-2799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number006662
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2147
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: