Provider Demographics
NPI:1417408097
Name:CABRERA, ASTRID PILAR (DC)
Entity type:Individual
Prefix:
First Name:ASTRID
Middle Name:PILAR
Last Name:CABRERA
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 1:4290 BELLS FERRY RD NW
Mailing Address - Street 2:118
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-7140
Mailing Address - Country:US
Mailing Address - Phone:787-548-0427
Mailing Address - Fax:770-924-4713
Practice Address - Street 1:4290 BELLS FERRY RD NW
Practice Address - Street 2:118
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-7140
Practice Address - Country:US
Practice Address - Phone:787-548-0427
Practice Address - Fax:770-924-4713
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-19
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009646111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor