Healthcare Provider Details

I. General information

NPI: 1730830175
Provider Name (Legal Business Name): SEHWA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2022
Last Update Date: 01/18/2022
Certification Date: 01/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10820 ABBOTTS BRIDGE RD STE 310
DULUTH GA
30097-5783
US

IV. Provider business mailing address

10820 ABBOTTS BRIDGE RD STE 310
DULUTH GA
30097-5783
US

V. Phone/Fax

Practice location:
  • Phone: 678-822-0909
  • Fax:
Mailing address:
  • Phone: 678-822-0909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: AEYOUNG KIM
Title or Position: OWNER
Credential:
Phone: 678-822-0909