Provider Demographics
NPI:1194725556
Name:GOMARKO, JAMI MICHELE (DC)
Entity type:Individual
Prefix:DR
First Name:JAMI
Middle Name:MICHELE
Last Name:GOMARKO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 WINTERSET PKWY SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-6545
Mailing Address - Country:US
Mailing Address - Phone:770-977-5599
Mailing Address - Fax:
Practice Address - Street 1:3065 S COBB DR SE
Practice Address - Street 2:SUITE B
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-7809
Practice Address - Country:US
Practice Address - Phone:770-432-1164
Practice Address - Fax:770-434-8262
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2012-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007183111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCHNLMedicare ID - Type Unspecified