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General NPI Number Information
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NPI Number | 1023421914
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Entity Type | Organization
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Legal Business Name | DANA HEALTH AND WELLNESS CENTER INC
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Dates
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Enumeration Date | 06/09/2014
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Last Update Date | 06/09/2014
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Provider Practice Location Address
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Address Line | 2472 PLEASANT HILL RD SUITE 203A
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City | DULUTH
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State | GA
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Zip | 30096-1746
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Country | US
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Telephone | 770-623-9229
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Fax | 866-868-8705
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Provider Business Mailing Address
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Address Line | 2472 PLEASANT HILL RD SUITE 203A
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City | DULUTH
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State | GA
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Zip | 30096-1746
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Country | US
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Telephone | 770-623-9229
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Fax | 866-868-8705
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Authorized Official
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Title or Position | PRESIDENT
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Name | WOO JIN KIM
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Credential | DC
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Telephone | 770-623-9229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 27746
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License Number State | GA
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