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General NPI Number Information
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NPI Number | 1063533073
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Entity Type | Individual
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Provider Name | PHYLLIS ANN CARUSOS DC
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Gender | Female
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 227 SANDY SPRINGS PL NE SUITE J
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City | ATLANTA
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State | GA
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Zip | 30328-5918
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Country | US
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Telephone | 404-705-9339
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Fax | 404-705-9133
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Provider Business Mailing Address
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Address Line | 227 SANDY SPRINGS PL NE SUITE J
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City | ATLANTA
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State | GA
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Zip | 30328-5918
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Country | US
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Telephone | 404-705-9339
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Fax | 404-705-9133
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5403
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1661
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1946
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License Number State | SC
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