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General NPI Number Information
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NPI Number | 1154642569
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Entity Type | Individual
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Provider Name | MARRESA DECEMBER JONES D.C.
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Gender | Female
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Dates
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Enumeration Date | 06/20/2010
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Last Update Date | 08/28/2015
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Provider Practice Location Address
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Address Line | 335 UPPER RIVERDALE RD SUITE A8
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City | JONESBORO
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State | GA
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Zip | 30236-1099
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Country | US
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Telephone | 770-629-1552
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Fax |
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Provider Business Mailing Address
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Address Line | 511 COLUMNS DR
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City | LITHIA SPRINGS
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State | GA
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Zip | 30122-3133
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Country | US
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Telephone | 404-641-3817
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 31498
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License Number State | CA
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