Individual
MRS. WILMA BLAKE FAULKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC., DIPL O.M.
Contact information
Practice address
4900 IVEY RD NW, SUITE 820, ACWORTH, GA 30101-4001
(770) 975-9233
Mailing address
4806 DAVENPORT TRCE NW, ACWORTH, GA 30101-3974
(336) 671-0186
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
371
GA
171100000X
Acupuncturist
496
NC
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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