Provider Demographics
NPI:1114638061
Name:CAMPBELL, WESLEY LLOYD II (DC)
Entity Type:Individual
Prefix:DR
First Name:WESLEY
Middle Name:LLOYD
Last Name:CAMPBELL
Suffix:II
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 1:3168 US 278 NW
Mailing Address - Street 2:SUITE #2
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014
Mailing Address - Country:US
Mailing Address - Phone:770-637-6953
Mailing Address - Fax:
Practice Address - Street 1:3168 U.S.278 NW
Practice Address - Street 2:SUITE #2
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014
Practice Address - Country:US
Practice Address - Phone:770-637-6953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010223111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty