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General NPI Number Information
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NPI Number | 1376073577
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Entity Type | Individual
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Provider Name | RACHEL JAFFE WILSON
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Gender | Female
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Dates
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Enumeration Date | 06/20/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 609 GARAMOND PL
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-2606
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Country | US
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Telephone | 770-365-0487
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Fax | 770-365-0487
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Provider Business Mailing Address
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Address Line | 301 RAINTREE BND
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-2228
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Country | US
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Telephone | 770-365-0487
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 401
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License Number State | GA
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