Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | CHIR010285 | GA |
NPI | 1326671363 |
---|---|
Provider Name | Yoonho Shin |
First Address | Duluth, GA 30096-5102 |
Second Address | Duluth, GA 30096-5102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2020 |
Last Update Date | 18/02/2020 |