Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | CHIR008932 | GA |
NPI | 1023381704 |
---|---|
Provider Name | Dr. Jinjiang Li |
First Address | Alpharetta, GA 30004 |
Second Address | Alpharetta, GA 30004-6806 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2012 |
Last Update Date | 26/08/2021 |