Provider Demographics
NPI:1174268924
Name:WELCH, JESSICA J (DC)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:J
Last Name:WELCH
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 1:3677 HIGHWAY 5
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-6930
Mailing Address - Country:US
Mailing Address - Phone:770-942-9494
Mailing Address - Fax:770-942-9500
Practice Address - Street 1:3677 HIGHWAY 5
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-6930
Practice Address - Country:US
Practice Address - Phone:770-942-9494
Practice Address - Fax:770-942-9500
Is Sole Proprietor?:No
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010293111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor