Provider Demographics
NPI:1275969024
Name:SEWARD, JESSIE MAE (DC, LMT)
Entity Type:Individual
Prefix:DR
First Name:JESSIE
Middle Name:MAE
Last Name:SEWARD
Suffix:
Gender:F
Credentials:DC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2231 ROBINSON RD NE STE C
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-2289
Mailing Address - Country:US
Mailing Address - Phone:770-973-5775
Mailing Address - Fax:770-973-2257
Practice Address - Street 1:2231 ROBINSON RD NE STE C
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-2289
Practice Address - Country:US
Practice Address - Phone:770-973-5775
Practice Address - Fax:770-973-2257
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR002622111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor