Provider Demographics
NPI:1588982698
Name:AMUNE, AUGUSTINA ESHOVO (DC)
Entity type:Individual
Prefix:
First Name:AUGUSTINA
Middle Name:ESHOVO
Last Name:AMUNE
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 1:10945 STATE BRIDGE RD # 401-287
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-8164
Mailing Address - Country:US
Mailing Address - Phone:770-754-4556
Mailing Address - Fax:
Practice Address - Street 1:11105 STATE BRIDGE RD STE 400
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-7480
Practice Address - Country:US
Practice Address - Phone:770-754-4556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008653111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor