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General NPI Number Information
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NPI Number | 1467993766
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Entity Type | Organization
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Legal Business Name | DUSTIN E ALBANESE LLC
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Dates
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Enumeration Date | 03/20/2017
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Last Update Date | 03/20/2017
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Provider Practice Location Address
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Address Line | 6495 SHILOH RD STE 110
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City | ALPHARETTA
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State | GA
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Zip | 30005-1635
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Country | US
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Telephone | 770-740-9200
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Fax | 770-752-5607
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Provider Business Mailing Address
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Address Line | 6495 SHILOH RD STE 110
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City | ALPHARETTA
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State | GA
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Zip | 30005-1635
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Country | US
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Telephone | 770-740-9200
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Fax | 770-752-5607
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. DUSTIN EVAN ALBANESE
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Credential | D.C.
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Telephone | 770-740-9200
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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 | CHIR009702
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License Number State | GA
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