Individual
JOQUAN CHARLESWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
5498 FRONTIER CT, ELLENWOOD, GA 30294-4386
(678) 879-7575
Mailing address
5498 FRONTIER CT, ELLENWOOD, GA 30294-4386
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIRO11238
GA
Other
Enumeration date
11/22/2024
Last updated
11/22/2024
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