Provider Demographics
NPI:1841661923
Name:JAMANDA HEALTHCARE SERVICES PC
Entity type:Organization
Organization Name:JAMANDA HEALTHCARE SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:404-691-8881
Mailing Address - Street 1:3050 MARTIN LUTHER KING JR DR SW
Mailing Address - Street 2:SUITE J-4
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30311-1500
Mailing Address - Country:US
Mailing Address - Phone:404-691-8881
Mailing Address - Fax:404-691-8999
Practice Address - Street 1:3050 MARTIN LUTHER KING JR DR SW
Practice Address - Street 2:SUITE J-4
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30311-1500
Practice Address - Country:US
Practice Address - Phone:404-691-8881
Practice Address - Fax:404-691-8999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006257111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty