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General NPI Number Information
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NPI Number | 1306022801
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Entity Type | Individual
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Provider Name | HEIDI AMANDA NORMAN D.C.
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Gender | Female
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Dates
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Enumeration Date | 01/14/2008
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Last Update Date | 11/19/2015
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Provider Practice Location Address
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Address Line | 6460 HIGHWAY 92 SUITE 100
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City | ACWORTH
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State | GA
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Zip | 30102-2998
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Country | US
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Telephone | 770-926-2212
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Fax | 770-926-2242
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Provider Business Mailing Address
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Address Line | 1203 F OLD TROLLEY RD SUITE B
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City | SUMMERVILLE
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State | SC
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Zip | 29485-5296
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Country | US
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Telephone | 843-486-0999
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Fax | 843-486-0989
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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 | 3773
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License Number State | SC
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