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General NPI Number Information
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NPI Number | 1275811267
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Entity Type | Organization
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Legal Business Name | ADVANCED HEALTH AND WELLNESS CENTER, INC.
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Dates
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Enumeration Date | 07/26/2011
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Last Update Date | 07/26/2011
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Provider Practice Location Address
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Address Line | 35 JACKSON ST
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City | NEWNAN
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State | GA
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Zip | 30263-1945
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Country | US
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Telephone | 770-253-5040
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Fax | 770-253-5040
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Provider Business Mailing Address
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Address Line | 35 JACKSON ST
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City | NEWNAN
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State | GA
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Zip | 30263-1945
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Country | US
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Telephone | 770-253-5040
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Fax | 770-253-5040
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Authorized Official
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Title or Position | OWNER
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Name | DR. JASON AARON BAILEY
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Credential | D.C.
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Telephone | 770-253-5040
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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 | CHIR007611
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License Number State | GA
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