Organization
RESTORATION SPINE & SPORT CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN R WILSON DC (CEO)
(678) 594-3579
Entity
Organization
Contact information
Practice address
110 EVANS MILL DR STE 309, DALLAS, GA 30157-1623
(678) 594-3579
Mailing address
110 EVANS MILL DR STE 309, DALLAS, GA 30157-1623
(678) 594-3579
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
03/27/2019
Last updated
03/27/2019
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