# ATLANTA SPINE AND WELLNESS - ROSWELL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548151954
- **Authorized official:** JESSICA MARIE OUDEKERK DC (OWNER)
- **Authorized official phone:** (404) 480-3311

## Contact information

- **Practice address:** 1792 WOODSTOCK RD STE 450, ROSWELL, GA 30075-5615
- **Practice address phone:** (404) 480-3311
- **Practice address fax:** (770) 727-8136
- **Mailing address:** 1792 WOODSTOCK RD STE 450, ROSWELL, GA 30075-5615
- **Mailing address phone:** (404) 480-3311
- **Mailing address fax:** (770) 727-8136

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | Yes |
| 111N00000X | Chiropractor | — | — | Yes |

## Other

- **Enumeration date:** 07/14/2025
- **Last updated:** 09/02/2025