Provider Demographics
NPI:1871216887
Name:DE JESUS RODRIGUEZ, JORGE ANDRE (DC)
Entity type:Individual
Prefix:DR
First Name:JORGE
Middle Name:ANDRE
Last Name:DE JESUS RODRIGUEZ
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 1:3833 ROSWELL RD NE STE 107B
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-4432
Mailing Address - Country:US
Mailing Address - Phone:787-420-8858
Mailing Address - Fax:
Practice Address - Street 1:3833 ROSWELL RD NE STE 107
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-4432
Practice Address - Country:US
Practice Address - Phone:706-995-7974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-23
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010806111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor