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General NPI Number Information
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NPI Number | 1083666192
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Entity Type | Individual
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Provider Name | PORCIA DAWN EWING D.C.
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Gender | Female
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 147 NORTH AVENUE N.W.
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City | ATLANTA
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State | GA
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Zip | 30308
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Country | US
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Telephone | 404-892-1001
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Fax | 404-874-3826
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Provider Business Mailing Address
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Address Line | 7075 COATSWORTH DR
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-5940
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Country | US
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Telephone | 678-983-0688
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Fax | 770-506-0689
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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 | CHIR007881
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License Number State | GA
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