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General NPI Number Information
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NPI Number | 1194820746
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Entity Type | Individual
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Provider Name | KATHERINE A WURST DC
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Gender | Female
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 02/05/2010
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Provider Practice Location Address
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Address Line | 152 ROSWELL ST SE
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City | MARIETTA
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State | GA
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Zip | 30060-1945
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Country | US
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Telephone | 770-424-6222
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Fax | 770-424-6789
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Provider Business Mailing Address
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Address Line | 152 ROSWELL ST SE
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City | MARIETTA
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State | GA
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Zip | 30060-1945
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Country | US
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Telephone | 770-424-6222
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Fax | 770-424-6789
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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 | 2670
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License Number State | GA
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