Healthcare Provider Details

I. General information

NPI: 1780091710
Provider Name (Legal Business Name): HAN CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2014
Last Update Date: 07/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3499 DULUTH PARK LN 210
DULUTH GA
30096-5714
US

IV. Provider business mailing address

3499 DULUTH PARK LN 210
DULUTH GA
30096-5714
US

V. Phone/Fax

Practice location:
  • Phone: 770-622-8383
  • Fax: 770-622-8384
Mailing address:
  • Phone: 770-622-8383
  • Fax: 770-622-8384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR007571
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number328
License Number StateGA

VIII. Authorized Official

Name: SEUNGGOO CHUNG
Title or Position: OWNER
Credential: DC
Phone: 770-622-8383