Healthcare Provider Details

I. General information

NPI: 1295548444
Provider Name (Legal Business Name): NA LIU DC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4385 KIMBALL BRIDGE RD STE 204
ALPHARETTA GA
30022-4474
US

IV. Provider business mailing address

4502 ORCHARD GROVE DR
AUBURN GA
30011-2385
US

V. Phone/Fax

Practice location:
  • Phone: 678-404-5766
  • Fax:
Mailing address:
  • Phone: 678-898-6889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR011338
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: