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General NPI Number Information
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NPI Number | 1265651186
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Entity Type | Organization
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Legal Business Name | KJ GROUP ENTERPRISES, INC.
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1291 OLD PEACHTREE RD NW 223
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City | SUWANEE
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State | GA
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Zip | 30024-2021
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Country | US
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Telephone | 770-817-0510
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Fax | 770-817-0511
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Provider Business Mailing Address
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Address Line | 1291 OLD PEACHTREE RD NW 223
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City | SUWANEE
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State | GA
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Zip | 30024-2021
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | MR. KI MIN KIM
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Credential |
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Telephone | 770-817-0510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 000159
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License Number State | GA
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