Provider Demographics
NPI:1033835475
Name:FERDINAND, JILLIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JILLIAN
Middle Name:
Last Name:FERDINAND
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 HICKORY RD
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30115-9600
Mailing Address - Country:US
Mailing Address - Phone:678-880-6616
Mailing Address - Fax:
Practice Address - Street 1:120 HICKORY RD
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30115-9600
Practice Address - Country:US
Practice Address - Phone:678-880-6616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010725111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor