Provider Demographics
NPI:1568829976
Name:PAULK, ALEXANDRO JERRY (DC)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRO
Middle Name:JERRY
Last Name:PAULK
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 1:1055 WINTHROPE CHASE DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-2394
Mailing Address - Country:US
Mailing Address - Phone:678-283-4995
Mailing Address - Fax:
Practice Address - Street 1:5755 N POINT PKWY
Practice Address - Street 2:SUITE 4
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-1142
Practice Address - Country:US
Practice Address - Phone:678-283-4955
Practice Address - Fax:888-819-7891
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-15
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009631111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor