Provider Demographics
NPI:1104974435
Name:ROMAN, JAMES THOMAS (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:THOMAS
Last Name:ROMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1887 BALMORAL RD SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-3723
Mailing Address - Country:US
Mailing Address - Phone:770-630-2598
Mailing Address - Fax:770-436-3053
Practice Address - Street 1:1180 MCKENDREE CHURCH RD
Practice Address - Street 2:202
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30043-5272
Practice Address - Country:US
Practice Address - Phone:770-817-0833
Practice Address - Fax:770-817-0832
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GACHIR007192111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor