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General NPI Number Information
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NPI Number | 1699912519
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Entity Type | Organization
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Legal Business Name | WETZEL CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 01/14/2009
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Last Update Date | 01/14/2009
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Provider Practice Location Address
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Address Line | 4403 NORTHSIDE PKWY NW SUITE 1101
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City | ATLANTA
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State | GA
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Zip | 30327-3094
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Country | US
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Telephone | 404-233-3386
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Fax | 404-233-3186
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Provider Business Mailing Address
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Address Line | 4403 NORTHSIDE PKWY NW SUITE 1101
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City | ATLANTA
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State | GA
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Zip | 30327-3094
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Country | US
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Telephone | 404-233-3386
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Fax | 404-233-3186
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Authorized Official
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Title or Position | OWNER
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Name | DR. HAMILTON GRANGER WETZEL
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Credential | D.C.
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Telephone | 404-233-3386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | CHIR008201
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License Number State | GA
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