Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | CHIR008710 | GA |
NPI | 1336434109 |
---|---|
Provider Name | Dr. Byung Yull Kim |
First Address | Duluth, GA 30096-3400 |
Second Address | Duluth, GA 30096-3400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2011 |
Last Update Date | 16/01/2013 |