Individual
KENNETH ROBERT WEIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1715 HOWELL MILL RD NW, C-12, ATLANTA, GA 30318-3121
(404) 350-8000
(404) 350-8072
Mailing address
1715 HOWELL MILL RD NW STE C12, ATLANTA, GA 30318-3117
(404) 350-8000
(404) 350-8072
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5608
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35ZCDQP
MEDICARE
GA
01
—
672394
BLUE CROSS BLUE SHIELD #
GA
Enumeration date
06/30/2006
Last updated
10/25/2010
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