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General NPI Number Information
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NPI Number | 1568829976
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Entity Type | Individual
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Provider Name | ALEXANDRO JERRY PAULK DC
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Gender | Male
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Dates
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Enumeration Date | 01/15/2016
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Last Update Date | 02/24/2016
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Provider Practice Location Address
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Address Line | 5755 N POINT PKWY SUITE 4
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City | ALPHARETTA
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State | GA
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Zip | 30022-1142
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Country | US
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Telephone | 678-283-4955
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Fax | 888-819-7891
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Provider Business Mailing Address
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Address Line | 1055 WINTHROPE CHASE DR
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City | ALPHARETTA
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State | GA
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Zip | 30009-2394
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Country | US
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Telephone | 678-283-4995
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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 | CHIR009631
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License Number State | GA
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