Provider Demographics
NPI:1932467115
Name:WOOLSEY, DAVID KENNETH (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KENNETH
Last Name:WOOLSEY
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 1:1100 OLD DAWSON VILLAGE RD
Mailing Address - Street 2:SUITE 010
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534
Mailing Address - Country:US
Mailing Address - Phone:706-429-0007
Mailing Address - Fax:
Practice Address - Street 1:1100 OLD DAWSON VILLAGE RD
Practice Address - Street 2:SUITE 010
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534
Practice Address - Country:US
Practice Address - Phone:706-429-0007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008971111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACHIR008971OtherDOCTOR OF CHIROPRACTIC