Provider Demographics
NPI:1962112490
Name:CARRAU-HERNANDEZ, GRACIELA (DC)
Entity type:Individual
Prefix:DR
First Name:GRACIELA
Middle Name:
Last Name:CARRAU-HERNANDEZ
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:PO BOX 392875
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-0048
Mailing Address - Country:US
Mailing Address - Phone:787-432-3986
Mailing Address - Fax:
Practice Address - Street 1:1300 PEACHTREE INDUSTRIAL BLVD STE 3110
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-4544
Practice Address - Country:US
Practice Address - Phone:787-432-3986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-23
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO10836111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor