Provider Demographics
NPI:1720478092
Name:PEARSON, JONATHAN ADAM (DC)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:ADAM
Last Name:PEARSON
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 1:5707 ABERCORN ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5505
Mailing Address - Country:US
Mailing Address - Phone:912-354-5073
Mailing Address - Fax:912-354-4221
Practice Address - Street 1:5707 ABERCORN ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5505
Practice Address - Country:US
Practice Address - Phone:912-354-5073
Practice Address - Fax:912-354-4221
Is Sole Proprietor?:No
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009445111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor