Provider Demographics
NPI:1144192493
Name:JYOTISHI, SHREYAS (DC)
Entity type:Individual
Prefix:DR
First Name:SHREYAS
Middle Name:
Last Name:JYOTISHI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 LAKE MEDLOCK DR
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30022-5681
Mailing Address - Country:US
Mailing Address - Phone:678-882-2493
Mailing Address - Fax:
Practice Address - Street 1:1400 HEMBREE RD STE 130
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5711
Practice Address - Country:US
Practice Address - Phone:404-671-8499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR066544111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor