Provider Demographics
NPI:1114311743
Name:WILLIAMS, JESSICA (DC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:WILLIAMS
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 1:4319 COVINGTON HWY
Mailing Address - Street 2:SUITE 311
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-1210
Mailing Address - Country:US
Mailing Address - Phone:404-286-6937
Mailing Address - Fax:
Practice Address - Street 1:4319 COVINGTON HWY
Practice Address - Street 2:SUITE 311
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-1210
Practice Address - Country:US
Practice Address - Phone:404-286-6937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR09376111N00000X, 111NP0017X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor