Provider Demographics
NPI:1033285481
Name:DESAULNIERS, JOEL LOUIS (DC)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:LOUIS
Last Name:DESAULNIERS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 CONCORD RD SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-2609
Mailing Address - Country:US
Mailing Address - Phone:770-432-9290
Mailing Address - Fax:770-319-6377
Practice Address - Street 1:545 CONCORD RD SE
Practice Address - Street 2:SE
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-2609
Practice Address - Country:US
Practice Address - Phone:770-432-9290
Practice Address - Fax:770-319-6377
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1836111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T97542Medicare ID - Type Unspecified