Healthcare Provider Details

I. General information

NPI: 1073237764
Provider Name (Legal Business Name): YES ACUPUNCTURE & CHIROPRACTIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2022
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2005 BOGGS RD STE 106
DULUTH GA
30096-4602
US

IV. Provider business mailing address

2005 BOGGS RD STE 106
DULUTH GA
30096-4602
US

V. Phone/Fax

Practice location:
  • Phone: 770-497-0882
  • Fax: 770-497-0861
Mailing address:
  • Phone: 770-497-0882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: MR. WOOJIN PARK PARK
Title or Position: MEMBER
Credential: L.AC.
Phone: 770-497-0882