Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CHIR008162 | GA |
N | 111NN1001X | Nutrition | CHIR008162 | GA |
N | 111NR0400X | Rehabilitation Chiropractor | CHIR008162 | GA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | CHIR008162 | GA |
NPI | 1427245984 |
---|---|
Provider Name | Dr. Do Young Kim |
First Address | Suwanee, GA 30024-2028 |
Second Address | Suwanee, GA 30024-2028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2007 |
Last Update Date | 21/06/2011 |