Provider Demographics
NPI:1609949833
Name:KRUTUL JONES, WENDY (DC)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:
Last Name:KRUTUL JONES
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 1:600 HOUZE WAY
Mailing Address - Street 2:A4
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-1435
Mailing Address - Country:US
Mailing Address - Phone:770-993-0040
Mailing Address - Fax:
Practice Address - Street 1:600 HOUZE WAY
Practice Address - Street 2:A4
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-1435
Practice Address - Country:US
Practice Address - Phone:770-993-0040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR004696111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCBWZMedicare ID - Type Unspecified