Provider Demographics
NPI:1063067742
Name:DRIVER, HANNAH R (DC)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:R
Last Name:DRIVER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:R
Other - Last Name:BATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3230 IVY LAKE DR
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30519-6731
Mailing Address - Country:US
Mailing Address - Phone:916-616-6897
Mailing Address - Fax:
Practice Address - Street 1:1630 BUFORD HWY
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-3629
Practice Address - Country:US
Practice Address - Phone:770-945-0561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-08
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010250111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor