Provider Demographics
NPI:1962228098
Name:BADER, ANA ALFONSINA
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:ALFONSINA
Last Name:BADER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4620 POWERS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-3427
Mailing Address - Country:US
Mailing Address - Phone:787-923-9215
Mailing Address - Fax:
Practice Address - Street 1:4620 POWERS FERRY RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-3427
Practice Address - Country:US
Practice Address - Phone:787-923-9215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO10563111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor