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General NPI Number Information
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NPI Number | 1962224402
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Entity Type | Individual
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Provider Name | JUNG SUH
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Gender | Male
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 2240 MARSH LN STE 100
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City | CARROLLTON
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State | TX
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Zip | 75006-2697
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Country | US
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Telephone | 214-294-7246
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Fax |
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Provider Business Mailing Address
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Address Line | 8609 N MACARTHUR BLVD APT 2006
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City | IRVING
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State | TX
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Zip | 75063-4178
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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 |
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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 | 15562
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License Number State | TX
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