Provider Demographics
NPI:1285727677
Name:BARRETT, TAMMALA RENA (DC)
Entity type:Individual
Prefix:DR
First Name:TAMMALA
Middle Name:RENA
Last Name:BARRETT
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 1:2468 ANTWERP DR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-6522
Mailing Address - Country:US
Mailing Address - Phone:678-478-5492
Mailing Address - Fax:
Practice Address - Street 1:560 N JEFF DAVIS DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-1665
Practice Address - Country:US
Practice Address - Phone:770-719-8785
Practice Address - Fax:770-719-8715
Is Sole Proprietor?:No
Enumeration Date:2006-09-30
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO008280111N00000X
OK3625111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK244304101Medicare ID - Type Unspecified
GA511I350090Medicare PIN