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General NPI Number Information
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NPI Number | 1508219304
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Entity Type | Organization
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Legal Business Name | PARKS ACUPUNCTURE & HERBS LLC
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Dates
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Enumeration Date | 07/15/2016
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Last Update Date | 07/15/2016
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Provider Practice Location Address
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Address Line | 3631 PEACHTREE INDUSTRIAL BLVD STE 106
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City | DULUTH
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State | GA
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Zip | 30096-4851
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Country | US
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Telephone | 404-935-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 3631 PEACHTREE INDUSTRIAL BLVD STE 106
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City | DULUTH
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State | GA
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Zip | 30096-4851
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Country | US
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Telephone | 404-935-2200
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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. HOJUN PARK
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Credential |
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Telephone | 404-935-2200
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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 | 327
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License Number State | GA
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