Provider Demographics
NPI:1063691350
Name:VENTIMIGLIA, STEVEN R (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:R
Last Name:VENTIMIGLIA
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 1:270 KIGIAN TRL
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-5143
Mailing Address - Country:US
Mailing Address - Phone:678-520-4578
Mailing Address - Fax:
Practice Address - Street 1:2 RAVINIA DR
Practice Address - Street 2:SUITE 500
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30346-2104
Practice Address - Country:US
Practice Address - Phone:678-520-4578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007909111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor