Provider Demographics
NPI:1285608737
Name:ANDREYCAK, NANCY (DC)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:ANDREYCAK
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 1:1218 PACE RD
Mailing Address - Street 2:
Mailing Address - City:HIRAM
Mailing Address - State:GA
Mailing Address - Zip Code:30141-2118
Mailing Address - Country:US
Mailing Address - Phone:770-222-7606
Mailing Address - Fax:770-943-5084
Practice Address - Street 1:1218 PACE RD
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-2118
Practice Address - Country:US
Practice Address - Phone:770-222-7606
Practice Address - Fax:770-943-5084
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006411111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCGCHMedicare ID - Type Unspecified
GAU81716Medicare UPIN