Provider Demographics
NPI:1588540603
Name:SEGALL, SOPHIA (DC)
Entity type:Individual
Prefix:DR
First Name:SOPHIA
Middle Name:
Last Name:SEGALL
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 1:11 THIMBLEBERRY DR
Mailing Address - Street 2:
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-7915
Mailing Address - Country:US
Mailing Address - Phone:630-901-9584
Mailing Address - Fax:
Practice Address - Street 1:11 THIMBLEBERRY DR
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-7915
Practice Address - Country:US
Practice Address - Phone:630-901-9584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR011146111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor