Provider Demographics
NPI:1871795328
Name:HAKAMI, ALI R (DC)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:R
Last Name:HAKAMI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 FAIRBURN RD SW STE B4
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-2016
Mailing Address - Country:US
Mailing Address - Phone:404-505-5480
Mailing Address - Fax:404-505-5406
Practice Address - Street 1:550 FAIRBURN ROAD, SW, SUITE B-4
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331
Practice Address - Country:US
Practice Address - Phone:404-505-5480
Practice Address - Fax:404-505-5406
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO07509111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCHXPMedicare ID - Type UnspecifiedMEDICARE PROVIDER#