Provider Demographics
NPI:1962590588
Name:NEAL, FREDRICK (DC,CCEP,FASA)
Entity type:Individual
Prefix:MR
First Name:FREDRICK
Middle Name:
Last Name:NEAL
Suffix:
Gender:M
Credentials:DC,CCEP,FASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3949 HOLCOMB BRIDGE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-2207
Mailing Address - Country:US
Mailing Address - Phone:770-368-0333
Mailing Address - Fax:770-368-0133
Practice Address - Street 1:3949 HOLCOMB BRIDGE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-2207
Practice Address - Country:US
Practice Address - Phone:770-368-0333
Practice Address - Fax:770-368-0133
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2756111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor