Provider Demographics
NPI:1215154646
Name:NEAL, SHANDREIKA (DC)
Entity type:Individual
Prefix:DR
First Name:SHANDREIKA
Middle Name:
Last Name:NEAL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:SHAN
Other - Middle Name:
Other - Last Name:NEAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:2612 SHADOWOOD PKWY SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2365
Mailing Address - Country:US
Mailing Address - Phone:770-401-2414
Mailing Address - Fax:
Practice Address - Street 1:8200 MALL PKWY
Practice Address - Street 2:SUITE 180
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-6983
Practice Address - Country:US
Practice Address - Phone:777-777-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007604111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor