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General NPI Number Information
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NPI Number | 1033476932
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Entity Type | Organization
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Legal Business Name | DR. KENNETH R WEIL, P.C.
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Dates
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Enumeration Date | 04/16/2012
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Last Update Date | 04/16/2012
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Provider Practice Location Address
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Address Line | 1715 HOWELL MILL RD NW STE C12
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City | ATLANTA
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State | GA
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Zip | 30318-3117
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Country | US
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Telephone | 404-350-8000
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Fax | 404-350-8072
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Provider Business Mailing Address
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Address Line | 1715 HOWELL MILL RD NW STE C12
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City | ATLANTA
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State | GA
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Zip | 30318-3117
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Country | US
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Telephone | 404-350-8000
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. KENNETH ROBERT WEIL
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Credential | D.C.
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Telephone | 404-350-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5608
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License Number State | GA
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