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General NPI Number Information
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NPI Number | 1215826557
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Entity Type | Organization
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Legal Business Name | KOJINMO SPINE CLINIC INC
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 1295 OLD PEACHTREE RD NW STE 270
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City | SUWANEE
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State | GA
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Zip | 30024-2770
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Country | US
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Telephone | 404-932-9770
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Fax | 678-261-1680
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Provider Business Mailing Address
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Address Line | 1295 OLD PEACHTREE RD NW STE 270
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City | SUWANEE
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State | GA
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Zip | 30024-2770
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Country | US
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Telephone | 404-932-9770
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Fax | 678-261-1680
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Authorized Official
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Title or Position | CEO
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Name | JIN M KO
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Credential |
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Telephone | 404-932-9770
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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 |
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License Number State |
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