Organization
WILSON FAMILY CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB WESLEY WILSON D.C. (CEO)
(678) 205-1573
Entity
Organization
Contact information
Practice address
2498 JETT FERRY RD STE 100, DUNWOODY, GA 30338-3062
(678) 205-1573
(678) 205-1574
Mailing address
2498 JETT FERRY RD STE 100, DUNWOODY, GA 30338-3062
(678) 205-1573
(678) 205-1574
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR008587
GA
111NP0017X
Pediatric Chiropractor
CHIR008587
GA
111NR0200X
Radiology Chiropractor
CHIR008587
GA
Other
Enumeration date
12/22/2009
Last updated
11/26/2024
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