Individual
NICOLE JAMES WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
1736 BRANDEMERE DRIVE, AUSTELL, GA 30168
(404) 919-9037
Mailing address
1736 BRANDEMERE DR, AUSTELL, GA 30168-5341
(281) 543-5015
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIRO09405
GA
Other
Enumeration date
09/09/2021
Last updated
09/09/2021
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