Provider Demographics
NPI:1396102281
Name:DRUCKMAN, ELIAS (DC)
Entity type:Individual
Prefix:DR
First Name:ELIAS
Middle Name:
Last Name:DRUCKMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 ROSWELL RD APT 6B7
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-5012
Mailing Address - Country:US
Mailing Address - Phone:772-563-7489
Mailing Address - Fax:
Practice Address - Street 1:1950 SPECTRUM CIR SE STE 200
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8469
Practice Address - Country:US
Practice Address - Phone:855-444-2724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-22
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009591111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology