Provider Demographics
NPI:1881994077
Name:EARLY, WILLIAM PAUL (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:PAUL
Last Name:EARLY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:205 WALESKA RD
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-2400
Mailing Address - Country:US
Mailing Address - Phone:678-880-7576
Mailing Address - Fax:678-348-7177
Practice Address - Street 1:205 WALESKA RD
Practice Address - Street 2:SUITE 1C
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-2400
Practice Address - Country:US
Practice Address - Phone:678-880-7576
Practice Address - Fax:678-348-7177
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-22
Last Update Date:2017-01-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GACHIR008730111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I355421Medicare PIN