=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114884566
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WATTS WELLNESS CHIROPRACTIC INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/07/2026
-----------------------------------------------------
Last Update Date | 01/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 217 ARROWHEAD BLVD STE 3
-----------------------------------------------------
City | JONESBORO
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30236-1169
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-572-2766
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3236 WILDFLOWER RD
-----------------------------------------------------
City | REX
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30273-2452
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR OF CHIROPRACTIC
-----------------------------------------------------
Name | DR. KENNETH WATTS JR.
-----------------------------------------------------
Credential | DC
-----------------------------------------------------
Telephone | 850-346-7491
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------