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General NPI Number Information
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NPI Number | 1134935810
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Entity Type | Individual
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Provider Name | GAN LIU DC
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Gender | Male
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Dates
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Enumeration Date | 12/06/2024
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 3499 DULUTH PARK LN STE 110
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City | DULUTH
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State | GA
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Zip | 30096-5716
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Country | US
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Telephone | 770-623-9291
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Fax | 770-623-1308
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Provider Business Mailing Address
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Address Line | 49 HOPELAND DR
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City | SAVANNAH
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State | GA
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Zip | 31419-2018
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Country | US
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Telephone | 651-354-2382
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIR011282
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License Number State | GA
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