Provider Demographics
NPI:1689949554
Name:JONES, JERREL ANDRE (DC, LMT)
Entity Type:Individual
Prefix:
First Name:JERREL
Middle Name:ANDRE
Last Name:JONES
Suffix:
Gender:M
Credentials:DC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2915 RIPPLE CT
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2756
Mailing Address - Country:US
Mailing Address - Phone:404-936-5770
Mailing Address - Fax:
Practice Address - Street 1:1630 SCENIC HWY N STE Y
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-5685
Practice Address - Country:US
Practice Address - Phone:678-400-6711
Practice Address - Fax:470-592-6499
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-12
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT006503173C00000X, 225700000X
GACHIR010561111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No173C00000XOther Service ProvidersReflexologist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist