Individual
DR. JEAN LUIS SANTIAGO MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
777 CLEVELAND AVE SW STE 309, ATLANTA, GA 30315-7118
(404) 734-6122
Mailing address
2401 WINDY HILL RD SE APT 1759S, MARIETTA, GA 30067-8525
(787) 307-6639
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR010991
GA
Other
Enumeration date
07/03/2023
Last updated
07/03/2023
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