Healthcare Provider Details

I. General information

NPI: 1003769522
Provider Name (Legal Business Name): JADAH COLTHIRST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 PEACHTREE INDUSTRIAL BLVD STE 105
DULUTH GA
30097-8627
US

IV. Provider business mailing address

2730 PEACHTREE INDUSTRIAL BLVD STE 105
DULUTH GA
30097-8627
US

V. Phone/Fax

Practice location:
  • Phone: 470-708-8833
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0600X
TaxonomyElectroneurodiagnostic Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: