MEDICARE: DR. CLIFTON ROY WELDON D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CHIR009439	GA

General Provider Information

NPI Number	:	1245416114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLIFTON ROY WELDON D.C.

Provider Business Mailing Address
First Line	:	2330 WINDY HILL RD SE STE 200
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30067-8602
Country	:	US
Telephone Number	:	770-988-0988
Fax Number	:	770-988-8989

Provider Business Practice Location Address
First Line	:	2330 WINDY HILL RD SE STE 200
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30067
Country	:	US
Telephone Number	:	770-988-0988
Fax Number	:	770-988-8989

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2008
Last Update Date	:	02/14/2019

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