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General NPI Number Information
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NPI Number | 1730893140
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Entity Type | Individual
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Provider Name | LATISHA ELAINE JONES DC
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Gender | Female
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Dates
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Enumeration Date | 01/10/2023
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Last Update Date | 04/30/2024
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Provider Practice Location Address
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Address Line | 2150 SCENIC HWY SUITE 1218
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City | LAWRENCEVILLE
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State | GA
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Zip | 30045
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Country | US
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Telephone | 770-676-9826
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Fax |
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Provider Business Mailing Address
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Address Line | 1805 ROSWELL RD APT 11I
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City | MARIETTA
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State | GA
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Zip | 30062-3916
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Country | US
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Telephone | 256-750-0188
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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 | CHIR010665
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License Number State | GA
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